Digital cross-sectoral training with dynamic patient and situation simulation in the context of mass casualty incidents—insights from the research projects D2PuLs and D2PuLs PRO

Introduction Managing Mass Casualty Incidents (MCI) demands complex, cross-sectoral competencies. However, training these skills using traditional full-scale exercises is often limited by high resource requirements, low frequency, and a lack of patients (patho-)physiological dynamics. Against this backdrop, the research projects D2PuLs and D2PuLs PRO (Digital Dynamic Patient and Scene Simulation) developed a modular and adaptive digital simulation environment designed for interdisciplinary and cross-sectoral disaster response training. Methods A core element of this system is a dynamic physiology model that simulates (patho-)physiological changes and therapeutic interventions in real time, replacing static vital signs with realistic, intervention-dependent progressions. The platform facilitates configurable scenarios ranging from individual training on mobile devices to distributed large-scale exercises incorporating external situation simulators and physical simulation manikins. Results Preliminary results of initial field tests and subsequent surveys of Emergency Medical Services (EMS) personnel and clinical teams showed the fundamental technical and didactic applicability of the system across the entire rescue chain—from initial care and triage to transport and trauma room management. The results provide solid, albeit preliminary, indications that the system can be successfully utilized to train decision-making, triage, and resource management across sector boundaries, while providing digital data foundation for debriefings. Although the complexity of the available medical interventions initially placed high demands on user operation, the modular architecture proved effective in adapting scenarios to specific learning objectives. Discussion The study concludes that dynamic digital simulations represent a scalable and valid supplement to practical exercises, serving to sustainably strengthen operational confidence in disaster medicine.