• Joseph G Kotora, Terry Clancy, Lauren Manzon, Varun Malik, Robert J Louden, and Mark A Merlin.
• Fellowship, EMS and Disaster Medicine, Newark Beth Israel Medical Center, Newark, New Jersey.
• Am J Disaster Med. 2014 Jan 1;9(1):39-51.

BackgroundAn active shooter in the emergency department (ED) presents a significant danger to employees, patients, and visitors. Very little education on this topic exists for healthcare workers. Using didactic and scenario-based training methods, the authors constructed a comprehensive training experience to better prepare healthcare workers for an active shooter.MethodsThirty-two residents, nurses, and medical students participated in a disaster drill onboard a US military base. All were blinded to the scenarios. The study was approved by the institutional review board, and written consent was obtained from all participants. Each participant completed a 10-item pretest developed from the Department of Homeland Security's IS:907 Active Shooter course. Participants were exposed to a single active shooter scenario followed by a didactic lecture on hostage recovery and crisis negotiation. Participants were then exposed to a scenario involving multiple shooters. Many of the participants were held hostage for several hours. The training concluded with a post-test and debrief. Paired Student's t-test determined statistical significance between the pretest and post-test questionnaire scores.ResultsPaired Student's t-tests confirmed a statistically significant difference between the pretest and post-test scores for the subjects, as a whole (p < 0.002 [-0.177, -0.041]). There was no difference in scores for nurses (p = 1 [-1.779, 1.779]). The scores for resident physicians (p < 0.01 [-0.192, -0.032]) and medical students (p < 0.01 [-0.334, -0.044]) were found to be significant.ConclusionsDidactic lectures, combined with case-based scenarios, are an effective method to teach healthcare workers how to best manage an active shooter incident.

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