The global pool of simulation exercise materials in health emergency preparedness and response: a scoping review with a health system perspective

McDarby, Geraldine; Reynolds, Lindy; Zibwowa, Zandile; Syed, Shams; Kelley, Ed; Saikat, Sohel

There was no involvement of patients or the public in this study, in either the design of the methods or in the conduct of the study. resulTs simex consideration of health system building blocks The majority (63%) of the materials (n=51) identified exclusively tested preparedness and response to a PHE, without considering them as typical functions of a resilient health system (figure 2). A limited number were identified that tested aspects of health system resilience or recovery (figure 2). The categorisation of the scope of material was based on the research BMJ Global Health team's interpretation, that is, if the exercises dealt with preparing and responding to a PHE or if they dealt with aspects of recovery or response. A few materials self-identified as testing health security or testing for contingency, and so warranted extra categories. The materials identified looked at aspects of health security across different geographical levels (international, national, regional and facility); they more frequently examined the regional/ district (43%) and facility levels (31.4%) ( figure 3) . The most frequent hazard type (37%) simulated was biological which included pandemic influenza and other emerging infections ( figure 4) .