Dissertation Title: Evaluating the Effectiveness and Impact of This is a TEST

Dissertation Chair: Dr. Harry Heiman

Dissertation Abstract:

OBJECTIVE: Despite the potential high impact and devastation of a radiation emergency, preparedness and response efforts for radiation continue to be a low priority and ever-growing gap in the United States and globally. Exercises, a method of improving preparedness capabilities, have been found to be lacking in engagement and the facilitation of coordination and collaboration among different response partners across the government. The Centers for Disease Control and Prevention (CDC) has developed a serious game for radiation emergency response to address these gaps and align with current exercise frameworks called This is a TEST, a Training and Exercise Simulation Tool (TEST).

METHODS: To determine if TEST is meeting its design objectives and filling gaps in available exercise materials, we evaluated participant feedback through anonymous surveys (N = 228) and focus groups following jurisdictional implementation of TEST as exercises across 11 host sites. We conducted descriptive analysis on survey data and sentiment analysis on focus group feedback. Spearman’s rank correlation was used to determine correlation between survey questions. Research questions were answered by combining Likert-type questions into Likert scale data following appropriate Cronbach alpha. One way ANOVA and t-tests were performed to determine significant differences between subgroups.

RESULTS: Most respondents felt that TEST provided an engaging experience (96.5%) and 97.4% felt satisfied. Regardless of board game enjoyment, respondents (94.7%) felt they had a greater understanding of radiation operations. Major planning gaps identified by respondents included lack of adequate resources and staffing.

CONCLUSIONS: Overall, the findings from this evaluation showed that TEST was successful in meeting its design objectives. The serious game format of TEST was found to be acceptable to different response organizations and unique in the value it brought to the radiation preparedness exercise cycle. These data show that serious games, such as TEST, increase engagement during exercises and provide an environment for response agencies to learn about each other’s roles and how best to coordinate and plan together before an emergency.  TEST was impactful in bridging communication gaps and driving urgency to work together to update radiation response plans, overall improving jurisdictional response capacity.