Board Game: An Effective Way for Novice Trainees to Learn Incident Command System

This study, conducted at National Taiwan University Hospital, evaluates whether a board game can teach the incident command system (ICS) to novice disaster medical assistance team (DMAT) trainees as effectively as a traditional lecture. The authors designed a turn-based board game in which participants, organized into disaster response teams of 15 to 25 people, played roles within a simplified ICS structure while responding to simulated earthquakes, floods, fires, and chemical spills in a model town. The comparison involved 17 novices in a 2020 board-game session and 25 novices in a 2021 lecture session, each lasting 90 minutes, with a 20-question multiple-choice test administered before and after each intervention.

Both groups improved significantly. The board-game group's mean score rose from 56 to 75 (p = .001), and the lecture group's rose from 58 to 74 (p = .002). An ANOVA found no significant difference in score improvement between the two groups (p = .6), which the authors interpret as evidence that the game is comparably effective. Participants were predominantly nurses, and the groups differed in age distribution, with the board-game group containing more participants over 50.

The study's design has notable constraints. It was a non-randomized cohort comparison with non-random sampling, raising the possibility of selection bias, and it measured only immediate post-intervention knowledge rather than long-term retention. Subjective engagement was not assessed, and the game was facilitated by an instructor, so its effectiveness without facilitation remains untested. The authors position the work as the first board game study in ICS education and suggest board games may serve as a primary or introductory tool for novice responders, while calling for further research on retention and broader applications in disaster medicine.