Development and effectiveness of tabletop exercises in preparing health practitioners in violence prevention management : a sequential explanatory mixed methods study

Background: Workplace violence in healthcare remains a significant issue for healthcare professional, in terms of risk to patients and staff. One part of a workplace violence prevention and management programme is to educate staff in their response to critical events. Drawn from the disaster management literature, tabletop exercises were used in this study to simulate workplace violence and educate staff on the appropriate emergency response during a violent event. The use of tabletop exercise in this context is a novel approach to workplace violence prevention management. Aim and objective: This study describes the development and effectiveness of tabletop exercises in preparing health practitioners in violence prevention and management emergency response systems. Methods: Using a sequential explanatory mixed method design. The study comprised of two phases 1) quasi–experimental (quantitative) and 2) focus group (qualitative) to evaluate the effectiveness of the violence prevention management tabletop exercises. COREQ guidelines were followed the qualitative arm of the study and the TREND statement for the quantitative part of the study. Results: Statistically significant improvements in healthcare professional confidence levels were found two weeks post the tabletop exercises. A post focus group revealed three categories concerning the participant's experiences of the tabletop exercises, (role clarity, adult learning and organisational support). Conclusion: Tabletop exercise may provide a, low cost, context specific novel approach to educating staff in emergency violence response systems at a tertiary referral hospital. Educators and policy makers may consider the use of tabletop exercises in the ongoing work in preparing health care staff for workplace violence. Relevance to clinical practice: Successful tabletop exercises should consider a local ward level context, the use of adult learning principles, have high level organisational support and cover role clarity as a key learning area.