By Lizamishel Boateng
New Haven Promise Scholar
On June 16, The Yale School of Nursing (YSN) Simulation Team conducted its cumulative assessment for first-year Graduate Entry Prespecialty in Nursing (GEPN) students: a mass-casualty disaster simulation in partnership with Yale New Haven EMS Center and Nelson Ambulance.
Nurse Midwifery student Shlomit Grullon ’25 MSN said the academic exercise began to feel real right away.
“Despite being aware that it was a simulation, the experience felt incredibly authentic and intense,” Grullon said. “I was immediately struck by the chaotic atmosphere: the noise, people on the floor and chairs, some alive and others deceased. The first individual I came across had suffered severe burns, and my initial concern was the possibility of them going into a hyperkalemic shock. The only skill at my disposal was assuring them that the triage team was en route to provide assistance.”
Students had no prior knowledge of what kind of disaster they were going to encounter.
Pediatric Nurse Practitioner Primary Care student Anita Onuoha ’25 MSN described the chaos of what she found:
“[It] was a concert gone wrong and when we encountered the scene there was smoke everywhere and continuous loud noise. There were various sources of stimulation and staying calm was initially not an option at first. The way I was able to calm down was to go over the tasks I had to do as a team leader.”
Some of those tasks include triaging patients using a color-coded system. A green tag is assigned to victims who are stable; yellow tags denote people who need intervention; red tags signify an immediate need to be transported to the hospital; and black tags are used for victims assessed to be deceased.
A Unique Learning Experience
Assistant Dean for Simulation and Clinical Innovation Christine Rodriguez, DNP, APRN, FNP-BC, MDiv, explained the unique advantages of simulation practice.
“The disaster simulation gives our students an opportunity to apply what they’ve learned so far during their first year at GEPN through a realistic intensive exercise,” Dr. Rodrigueze said. “The simulation provides students an example of what sim pedagogy can do, and the cumulative assessment leaves our students feeling more empowered and confident about how they can assist victims during a real disaster.”
Family Nurse Practitioner student Michael Garza ’25 MSN said the exercise certainly did that for him.
“I am so grateful to YSN for providing us with this immersive experience!” Garza said. “While I would not consider myself an expert in providing disaster relief, I now feel much more confident that I would be an asset in providing assistance should the occasion ever present itself.”
The Role of Staff Volunteers
Every year, staff volunteers also play a critical role in the disaster simulation. As victim volunteers, they spend the day acting out assigned characteristics and sharing their vital signs to help students assess their condition. In addition to wigs, staff volunteers also often wear moulage makeup, which gives the appearance of burns or wounds.
Program Manager for the Online MSN Program Christelle Luchsinger acted the role of a pregnant woman with minor injuries.
“I found participating in the simulation a fun exercise,” Luchsinger said. “As staff outside the medical realm it was a great way to understand better what students go through when preparing for a disaster. Knowing that YSN nursing students train to be best prepared for anything possible is comforting. It also made me appreciate all the preparatory work and behind-the-scenes work that the simulation lab does: from fake injuries to making sure the EMT and medical professionals were here to support the event, it was quite the effort!”
Debriefing the Disaster Simulation
After the simulation concluded, an EMT guided students through the debrief, praising what went well and identifying areas for improvement. Groups discussed the importance of attending to high-risk victims first and communicating with team members and emergency services personnel at the scene of a disaster. Staff volunteers also chimed in about their experience as victims.
President Peter Salovey ’86 PhD, and Public Safety service dog Heidi also made an appearance to watch the last cohort of students tackle the disaster simulation.
President Salovey, whose mother practiced as a Registered Nurse for many years, later described observing the preparation, simulation, and debriefing as both inspiring and emotional.
Students Reflect on Lessons Learned
The mass-casualty disaster simulation is a defining milestone for GEPNs, and many shared their lessons learned of such an elaborate classroom day.
Family Nurse Practitioner student Oscar Anderson ’25 MSN said he will remember the importance of setting the scene:
“My biggest takeaways were around the importance of team communication and understanding what my goals are when I start,” he said. “Taking a minute to take in the scene and understand the layout, where people are located, where emergency vehicles are going to be coming in and out, and what’s around me.”
Psych-Mental Health NP student Adam Alam ’25 MSN applauded his peers for their teamwork:
“My peers were amazing at supporting each other and working together to accomplish the task at hand,” Alam said, then described how team members took on roles such as delegating tasks to keep options open, working with the triage units to assess decompensation, and identifying a critically injured patient and sending them to the hospital within minutes. “I am excited to work with my peers in the future,” he said.
Family Nurse Practitioner (FNP) student Molly Skinner-Day ’25 MSN said all the work to make the simulation feel authentic paid off.
“It’s amazing how your physiological response activates in a simulation like this, even though you know it’s not real,” Skinner-Day said. “My heart was racing, and I had a huge adrenaline rush, and then I was so tired afterwards! It really helps that the smoke, noise, and even smells of the situation were so realistic. I think as a learning activity, knowing how your body will react is helpful.”
Watch the Video
Please note that video of the mass-casualty disaster simulation shows an academic assessment in which all participants exhibit cosmetically applied injuries. The volunteers are acting out their roles as victims, and while no one was harmed during the exercise, the images may be disturbing to some viewers. Video content contains fake blood and special effects makeup to resemble burns and wounds.
Visit the YSN YouTube Channel for an in-depth look at the 2023 mass-casualty disaster simulation.