With the inevitability of earthquakes in California, disaster preparedness and evacuation focused on the safety of lives is of utmost importance. The health, welfare, and safety of children are of paramount importance, as children are left in the protection of school district officials. In 2005, California Legislature passed Assembly Bill 103 requiring that each school district have a safety disaster plan in place and charged the U.S. Department of Education to coordinate with Office of Emergency Preparedness to keep these materials current and updated (AB 103, Section 1).
In 1989, the United Nations Convention on the Rights of the Child, stated every child “capable of forming his or her own views the right to express those views freely in all matters affecting the child.” In January 2014, the National Advisory Committee on Children and Disasters (NACCD) was developed to provide advice and consultation on the planning, preparation, response, and recovery for the medical and public health needs of children during disasters. According to the National Center for Educational Statistics, about 56.6 million students were enrolled in 2019. Literature has well documented that children and adolescents react differently in disasters than adults. However, missing from the literature are the voices of the children and the students’ perception about readiness in preparation for disasters.
Simulating a Common Threat
Southern California contains several earthquake fault lines, which could generate a large earthquake. Given these multiple faults, it is likely that a strong earthquake could strike during school hours. Natural disasters such as earthquakes occur with little warning, with ground movement seldom the direct cause of injury or death. Most injuries in the 1994 Northridge, California earthquake occurred as a result of people falling, being hit by debris, or stepping on broken glass while leaving buildings. Therefore, schools are encouraged to practice evacuation drills. A typical drill is pre-announced and completed at a designated time and day. Students and teachers practice the “duck and cover and hold on” as directed. After the announcement, “The shaking has stopped,” students are assembled by faculty and evacuated to a “safe” area for attendance, then resume a normal class schedule. Considering potential debris in classrooms, an unexpected earthquake while students are present could lead to chaos and numerous injuries. As currently practiced, earthquake drills suggest children may be ill-prepared for real events. Despite annual drills, there remains minimal data to ascertain the experiences and feelings of students about earthquake readiness.
Simulation is a powerful educational tool but has not been widely used to assess earthquake preparedness with school-aged children. Virtual training tools offer educators the advantage of teaching risky behaviors without the risk of injury. Game-based virtual reality (VR) programs have been developed to teach fire safety, practice timely physical evacuation, and effectively demonstrate child skills of pedestrian safety in a fun, training environment.
A statewide earthquake drill, the Great California ShakeOut, is conducted annually. However, the School Site Council of a combined middle and high school was still concerned about earthquake safety. Despite annual shake-out participation, the majority of students:
- Could not describe what to do in the event of an earthquake;
- Would call 911; and
- Had no disaster planning at home.
An in-class earthquake simulation addition to the Great ShakeOut drill was conceived to increase realism, enhance student learning, assess earthquake preparation, and determine the adequacy of the schools’ response to a disaster. This simulation was approved by administration and all human protections reviewed by Institutional Review Board. Gathering and articulating student knowledge using earthquake simulation and surveys would enable increased understanding of reactions during an actual event and allow for realistic planning.
A Different Kind of ShakeOut
In May 2015, a school assembly introduced the earthquake simulation project to 185 students. Topics of preparedness, planning, and dangers at home and school were reviewed. Discussion revealed student knowledge about earthquake drills: the drill is announced, students get under the desks or tables, hold on until told, then line up with the teacher for attendance. Per faculty, a typical drill took 60 minutes and did not disrupt school. An electronic poll during the assembly revealed that 96 students did not have or were unsure about a family disaster plan, 89 did not feel ready for a disaster, and 96 reflected they knew what to do in a disaster.
Despite annual drills, most students: could not describe what to do in the event of an earthquake; would not call 911; and had no disaster planning at home.
The 2015 drill was planned to be different. A 15-item survey was developed and validated to evaluate actions of classmates and self, perceptions of safety, and earthquake preparation at school and home. Mixed methodology data were analyzed by SPSS and NVIVO as secondary data. An all faculty/staff meeting preceded the simulation drill, which included the principal reviewing the school disaster plan, explaining the purpose, goal, and importance of data gathering from the children’s perspective by survey completion and collection by faculty.
The Great Shake-Out Drill was scheduled on 15 October 2015 at 10:15 a.m. The high school Community Service Club (CSC) was recruited to help with the earthquake simulation, meeting with project leaders to plan the simulation. CSC members made “debris” using cardboard, Styrofoam sheets, and foam blocks to simulate earthquake damage like boulders, falling objects, and ceiling tiles. Painted clothing and red duct tape simulated bleeding injuries with ping pong balls, foam peanuts, and erasers representing broken glass. Gauze wrappings and trauma dressings were also splattered with fake blood for the simulation of more serious injuries. Details about the use of props was made known only to the principal. The purpose of the project was to assess the effectiveness of disaster preparation for the students by creating an atmosphere of realistic possibilities during a familiar and previously practiced earthquake drill. The goal of the survey evaluations was to examine:
- Student responses to the disaster simulation;
- Student perceptions of safety and disaster readiness of their campus; and
- Student disaster readiness at home.
Anonymous surveys were completed by 427 students after the 2015 drill and collected by faculty. However, not all students answered every question. After the drill, of the 427 who answered the questions, 58 represented the high school group of which 49 felt they were not ready for a disaster, and 378 felt they were ready for a disaster. Despite earthquake reminders, 43 respondents stated they forgot to drop, 60 forgot to cover, and 93 forgot to hold on. Regarding classmates, 15 did not see classmates duck, 49 did not see classmates cover, and 101 did not see classmates hold on. NVIVO results demonstrated that some students who were outdoors at the time of the shaking, ran into or toward the buildings to find shelter. Regarding disaster planning, 252 never had practiced a drill at home and 122 respondents reported they did not have a plan at home.
Faculty observations questioned elements of the disaster plan, such as placement of triage and morgue. The chaos demonstrated difficulty in tracking the whereabouts for students, as the “injured” or “incapacitated” teachers and students reported to the health aide or sheltered in place. By not evacuating to the blacktop, they were not included in the attendance. No one knew where they were or where they went. Previous earthquake drills had not included chaos, simulated injuries, or deceased disaster victims.
Research Insights & Limitations
Valuable insights were gained by adding simulation to the Great Shakeout drill, which tested the school’s disaster plan. Students and school personnel all felt that the simulation dramatically increased the impact of the drill.
Pew Research Center data from 2013, estimates that 30-50% students in middle school have cellphones, and up to three-quarters of teens have access to a smartphone. With 26% of the children on the surveys collected reporting they would dial 911, this statistic indicates that, in less than 15 seconds, potentially 250,000 calls to 911 would be made if 5th-12th grade children make the call. Presented to school authorities, a conversation ensued regarding how to notify parents/guardians without using the phone line system. One solution might be to design a district-wide emergency number system, where parents/guardians and students have access without using the phone system. This pre-set text system could be widely distributed and like the 911 system, the number would be easy to remember. Using technology, a student could access this number, provide a personal identifier, and enable parents/guardians to locate their child(ren).
Within 15 miles of one of several major fault zones and despite prediction of a major earthquake (Earthquake Country Alliance-California Earthquake Authority), a surprising 252 of the students reported they had never practiced a disaster drill at home. Additionally, 122 of students reported they do not have a plan. Southern California lies between several earthquake fault lines and experts predict a disaster disrupting school, community, and county is only a matter of time. This simulation demonstrated that much more preparedness efforts are needed.
The limitations of this research are the assumption that the students completed the surveys with accuracy. Also, the non-injurious debris thrown by the CSC members allowed for laughter and play, with some students not taking the drill serious. This was revealed as an observation by NVIVO responses with several students asking that this drill be repeated annually “until we get it right.”
Implications for School Disaster Plans
Students reported that the in-class simulation dramatically increased the realism of the drill and provided insights and suggestions about disaster preparedness improvement for school and homes. Simulation revealed weaknesses in the school disaster planning, calling for immediate changes, such as the evacuation route not walking past the morgue. The disaster plan instructed any person injured to report to the health aide. However, it was immediately clear that the overwhelming number of injured persons for one health aid necessitated a redesign of the plan. Finally, lacking accountability of the students not getting to the designated evacuation site was alarming when trying to keep track of the students.
Simulation added to the 2015 Great ShakeOut earthquake drill provided students with a realistic experience that increased understanding of disaster response and provided suggestions for future disaster preparedness. This simulation can be replicated and varied for individual schools and districts to test their own disaster plans.
Note: The name and specifics of the school site were kept hidden per the request of district officials.
Frances Dunniway, DNP, APRN-BC, CNS, is a family nurse practitioner, currently employed at VA Central California in Fresno, California. She has been a member of the San Bernardino County Disaster Medical Assistance Team since 1998, with deployments to Kosovo Refugees in 1998, WTC 2001, Hurricane Harvey 2018, Hurricane Florence 2019, as well as presidential inaugurations and funerals. She is dedicated to a lifetime of continuing education with interests in disaster preparedness and response, critical care, emergency, and family practice topics. She maintains various professional memberships and, for several years, volunteered in a homeless winter shelter providing free medical services. She currently participates on her community disaster planning committee. She earned a M.S.N. from Azusa Pacific University in 2002 as a Clinical Nurse Specialist, then completed a Family Nurse Practitioner post-masters credential in 2003. She completed her Doctorate of Nursing Practice (DNP) in 2012 from Western University of Health Sciences and post-doctoral research fellowship at University of Phoenix in 2014.