The Sukkah Drill: A Novel Approach to Incident Command Training

•The Sukkah Drill is a novel way to train mass casualty incident command skills.•Skills exercised are similar to those practiced in a large, expensive Field Drill.•Although simple design, the Sukkah Drill retains psychological fidelity.•Simplicity and affordability mean it can be recreated by nearly anyone, anywhere.•The Sukkah Drill therefore makes incident command training more accessible to all. First responders classically train to manage Mass Casualty Incidents (MCIs) by practicing incident command skills during Field Drills which mimic real-world conditions but are also costly and logistically complex to conduct. We therefore present the Sukkah Drill (named for its similarity to the hut used on the holiday of Sukkot) as an alternative, low-cost and simple innovative teaching method for MCI management. This study compares the Field and Sukkah Drills to better understand the advantages and disadvantages of this new training method. We compared the physical design features of the Sukkah and Field Drills qualitatively. A checklist of fourteen procedural actions was used to evaluate incident commanders during six Field Drills and seven Sukkah Drills, and the rates of performance of each action compared quantitively. Despite differences in design, thirteen of fourteen procedural actions were performed at similar rates across both Sukkah and Field Drills. The Sukkah Drill provides a comparable simulation experience to the Field Drill. Its simplicity and affordability may make it especially useful for lower-resource organizations.