The occurrence of natural disasters continues to increase globally each year. In 2021, there was a 13% increase in the frequency of disaster events, affecting 48% of the population and resulting in an 82% increase in economic losses (O.H.C.A., 2022) . According to the World Health Organization, over 1.6 billion people live in disaster-prone areas, conflict zones, and displacement areas. Approximately 190 million people are affected annually by natural or technological disasters such as hurricanes, tsunamis, volcanic eruptions, earthquakes, disease outbreaks, and accidents (Organization, 2019).

The impacts of disasters highlight the importance of disaster preparedness to reduce errors in disaster triage management (Saragih, 2019). Triage is sorting victims based on their injury severity or ABC (Airway, Breathing, and Circulation) condition. Triage involves sorting victims based on their level of urgency, both in the field and in hospitals (Sumarno et al., 2017). Through the implementation of triage, the accuracy of disaster victim treatment can improve public satisfaction with healthcare services. This helps build trust between the community and medical teams in handling disaster victims (Ainiyah et al., 2015). The START (Simple Triage and Rapid Treatment) method is the most commonly used and easily applicable triage system. This method categorizes victims into red, yellow, green, and black labels. Hoag Hospital And New Port Beach Fire And Marine first introduced the START method in California in 1980, evaluating three factors: RPM (Respirations, Perfusion, and Mental status) (Pranoto & Wibowo, 2020).

The consequences of incorrect and ineffective implementation of the START triage can result in delays in transporting victims to healthcare facilities, leading to increased mortality and disability rates (Bijani & Khaleghi, 2019). Furthermore, when START triage is not performed correctly, it can cause prioritization errors, resulting in delays in providing assistance to victims and increasing the number of fatalities (Connor et al., 2014).

The study by (Phukubye et al., 2019) revealed that most nurses (69%) had low knowledge about triage. Nurses can plan education and training programs independently or in collaboration with other healthcare professionals, using different techniques to enhance their knowledge, skills, and preparedness in disaster triage. Therefore, this scoping review is conducted to assist nurses in identifying disaster triage education and training programs. This study aims to (1) Identify the types of disaster triage education and training, (2) Determine the types of disaster triage covered in the education and training programs, and (3) Understand the outcomes of disaster triage education and training programs.

This scoping review follows the guidelines outlined in the PRISMA statement. The selected articles were assessed and summarized accordingly. We utilized the PCC framework to develop the eligibility criteria. P represents the population, which includes nurses and nursing students. C represents the concept of disaster triage education and training programs. C indicates the context, which includes experimental research designs and articles published from 2013 to 2023.

The inclusion criteria consist of a) nurses and nursing students; b) focusing on disaster triage and pre-hospital triage, with any outcome measures (knowledge, attitudes, skills, preparedness, motivation, self-efficacy, etc.); c) RCTs, quasi-experimental designs, pre-experiments, mixed methods with experiments; d) articles published between 2013 and 2023; e) articles in English. The exclusion criteria include a) volunteers; b) focusing on disaster nursing organization and policy; c) published before 2013 and after 2023; d) articles in languages other than English; e) review articles and qualitative designs. The literature search used five main databases: Pubmed, Scopus, ProQuest, EBSCO, and Wiley, see Table 1 for the database and Table 2 for keywords.

The 14 extracted articles were analyzed and summarized based on author, title, and year of publication, objectives, samples, types, and methods of education & training, type triage, the design used, and results. The author identifies 14 articles and presents them as a narrative table for inclusion in Table 3, see the detailed results of the review in Table 4 and Table 5.

The main findings of this scoping review are the existence of disaster triage education and training programs in the past 10 years. Some of these studies can help nurses identify the appropriate type of triage in disaster situations (Lumbu et al., 2013). Unpredictable disaster situations can negatively impact physical and environmental conditions (Dorasamy et al., 2020), necessitating swift and effective triage actions that require strategic handling (Mace & Mayer, 2013). The role of nurses in disaster triage should be emphasized, including education and training to enhance their abilities in conducting disaster triage (Eryilmaz et al., 2017) .

Nurses play a crucial role in disaster triage. Academic education programs should prepare students to perform triage during disasters. One way to enhance students' ability to perform triage during disaster emergencies is by providing triage-related education (Anwar, 2021). Disaster triage education and training programs, such as games and simulated scenarios, can enhance enjoyable learning motivation, particularly to improve students' experiences in learning, knowledge, and skills (Hung et al., 2020) .

In the context of disaster triage, these education and training programs cover knowledge related to disaster triage, indicating that senior nursing students have higher knowledge than junior nursing students (Hung et al., 2020). Regarding attitudes and skills in triage, diploma students have better skills than undergraduate nursing students (Xia et al., 2019). As for preparedness and triage accuracy, nurses show higher preparedness and better accuracy than nursing students. Moreover, motivation in disaster triage learning shows a significant change before and after the experiment, but no significant difference in learning motivation is observed between nurses and nursing students (Cicero et al., 2018).

These programs utilize various methods such as games, education, training, and simulations. Simulation-based programs are the most common, allowing nurses and nursing students to translate knowledge into practice in scenarios. Simulations have facilitated decision-making for nurses and nursing students by incorporating triage principles and clinical reasoning, including information gathering, problem identification, experiment delivery, and outcome assessment (Hung et al., 2020). One of the most commonly used triage methods is the START method, a simple method that can be executed within 60 seconds or less for each victim (Lumbu et al., 2013).

Triage-related training is carried out by randomly giving cards to each participant to categorize victims and enter each color code which should be 120 minutes (Xia et al., 2019). Triage training can also be provided by lecture and roleplay methods. In the lecture method, the material can be given within 90 minutes. The demonstration method can be done by providing a pre-designed scenario and a triage card to select victims, which are then included in the appropriate color label (Heidarzadeh et al., 2020). Training can also be done through video media given to participants for 15 minutes (Aghababaeian et al., 2013). Health education can be done with lectures and demonstration methods that have proven effective (Pouraghaei et al., 2017); (Rimadeni et al., 2021).

Simulation methods that can be applied in disaster triage learning are direct simulation, screenbased simulation, and virtual. Live simulations were conducted by providing scenarios including cases of death, multiple trauma, cardiac arrest, acute respiratory failure, fractures, panic attacks, and angina. Each scenario lasts for 5-10 minutes. The simulation process is reviewed by experts consisting of simulation experts, clinical nursing experts, and nursing professors. Participants were given a debriefing for 1 hour before the simulation and given a short presentation to describe the scenario for 5 minutes. The debriefing focused on how to combine clinical reasoning and triage principles in clinical decision-making with the integration of clinical reasoning model principles (Alshamari et al., 2023);(Cicero et al., 2018); (Hosseini et al., 2023) ; (Hu et al., 2021); (Lee et al., 2016). However, this study has limitations as it only uses five databases, so there may be relevant articles in other databases

This research demonstrates the presence of various disaster triage education and training programs in the past 10 years. The findings from this scoping review provide information about disaster triage education and training, including education, training, web-based triage games, and simulation with scenarios. Two types of disaster triage, START and SALT triage, are used to educate nurses and nursing students. The findings also discuss the outcomes of disaster triage education and training programs, which include knowledge, attitudes, skills, preparedness, triage accuracy, awareness, and motivation for learning.