Code Ready
Disaster Drill Helps Texas Tech Health El Paso Resident Physicians Lead the Way in Mass Casualty Incident Preparedness
Future health care heroes hone lifesaving skills through simulations to protect Far West Texas
The fictional life of 45-year-old Robert hung in the balance after a truck lost control and plunged into a local community center, causing a multiple-vehicle collision.
First responders located him through the chaotic crash site as he was among 44 “victims” in a meticulously crafted disaster scenario staged at Texas Tech Health El Paso on April 10 and 24, 2025. Designed to push responders and providers to the limits of their skills, these mass casualty incident drills transformed the campus into a dynamic, high-stakes disaster zone where every second counted.
The drill also aimed to prepare Texas Tech Health El Paso nursing students and resident physicians — doctors in the final stages of specialty training — to lead under extreme pressure.
Scott Crawford, M.D., FACEP, FSSH, CHSOS, director of Training and Educational Center for Healthcare Simulation (TECHS) at Texas Tech Health El Paso, sees these drills as a vital part of the university’s mission.
“These drills are not just academic exercises,” said Dr. Crawford. “They make sure our Borderplex is cared for by professionals ready for the worst.”
Resident Physicians at the Front Lines of Crisis
As part of the simulation, Robert had suffered damaging third-degree chemical burns and a serious leg injury. Assessing the severity of his injuries, paramedics placed a red triage wristband on his arm, signaling his critical condition, and scanned a barcode that would monitor his journey from the accident site to the hospital.
Resident physicians awaited Robert’s arrival outside the mock hospital at the Hunt School of Nursing. Decontamination showers stood at the ready to treat patients exposed to chemicals – in this case, chlorine and ammonia – released by the accident.
Resident physicians used a digital tablet to read the barcode on Robert’s wrist, assessed his condition and directed him to one of the trauma bays inside the Hunt School of Nursing’s advanced simulation labs.
One of the resident physicians performing triage, William Crowley, D.O., a third-year emergency medicine resident from Ashland, Oregon, shared his reflections on the drill.
“After the first few patients, we got the hang of it,” said Dr. Crowley. “We organized and leaned into teamwork, and we found our rhythm. This kind of training shows you how essential clear communication and decisive leadership are when lives are on the line.”
Lessons Grounded in Real-World Experience
Inside the trauma bay, physicians and nursing students sprang into action as Robert, now represented by a high-fidelity medical manikin, was wheeled in. Using a triage system to prioritize care, they collaborated swiftly, relying on clear communication and team-based decision-making to stabilize Robert’s deteriorating vital signs.
The manikin, programmed to react in real-time to interventions, added to the intense realism, requiring residents to adapt quickly as Robert’s condition fluctuated.
The sense of urgency felt during the drills was no accident. In the aftermath of the 2019 Walmart shooting in El Paso, Texas Tech Health El Paso medical residents, who had gone through their own mass casualty incident training, had been among the first to step forward, providing critical care when hospitals were flooded with victims.
James M. Brown, M.D., FACEP, the medical director of University Medical Center of El Paso’s emergency department and assistant professor of emergency medicine at the university, remembered that fateful day.
“I was off that day on a bike ride,” he recalled. “By the time I made my way to the hospital, the medical residents had prepared the department. They didn’t need me to tell them what to do. They just did it.”
That real-world tragedy highlighted why today’s residents must be trained to lead decisively under pressure — not just clinically, but emotionally.
At Texas Tech Health El Paso, emergency medicine residents are now required to complete disaster simulation training every 18 months. The program has expanded to include nursing, surgery, radiology residents, and El Paso Fire Department cadets, reinforcing the teamwork necessary for real-world emergency response.
“Disaster drills like these are essential,” Dr. Crawford said. “They teach our emergency medical residents how to perform technically while leading teams under the tremendous stress that real disasters bring.”
Developing Technical Skills — and Emotional Resilience
Throughout Robert’s simulated journey, the drill tested more than just technical abilities.
As complications arose — burns worsening, vital signs dropping — the five doctors and nurses in the room demonstrated their communication skills as they collaborated to save Robert’s life.
At the end of the exercise, resident physicians and their multidisciplinary partners attended a comprehensive debrief session. There, they shared feedback, reflected on their actions, and discussed the emotional weight of treating severely injured patients under pressure.
“Simulation training doesn’t just build clinical skills—it builds character and resilience,” Dr. Crawford emphasized. “It teaches our residents to lead with competence and compassion, even in the most uncertain moments.”
Preparing a Region — and a Future Generation
With over 330 medical residents and 250 nursing students, Texas Tech Health El Paso plays a crucial role in ensuring that highly skilled health professionals protect our Borderplex region. Community partners such as the West Texas Poison Center and UMC also contributed to the drill, mirroring the complexity of a real emergency response.
A 2024 study in the Journal of Medicine, Law & Public Health analyzed 28 studies on full-scale simulation exercises in hospital disaster preparedness. Results showed that institutions investing in regular disaster simulations significantly improve hospital preparedness, reduce response times, and increase survival rates when mass casualty incidents strike.
As Robert’s simulated journey concluded — stabilized, treated, and transitioned to intensive care — the experience left an indelible mark on the future health care heroes who fought to save him.
By placing resident physicians at the center of these trainings, Texas Tech Health El Paso ensures that when disaster strikes again, its future health care leaders will be ready.
About Texas Tech Health El Paso
Texas Tech Health El Paso serves 108 rural counties in West Texas and is a federally designated Hispanic-serving institution dedicated to preparing the next generation of health care heroes. Established as an independent university in 2013, Texas Tech Health El Paso is a uniquely innovative destination for medical, nursing, biomedical sciences and dental education.
With a focus on excellence in health care education, research, and clinical service, Texas Tech Health El Paso has graduated over 2,400 professionals over the past decade, and will include dental graduates beginning in 2025. For more information, visit ttuhscepimpact.org.