Flexible surge capacity aims to activate and utilize other resources than normally are\nsurged in a community during the primary and secondary surge capacity. The presence of\nalternative leadership, skilled and knowledgeable in hospital and prehospital emergency\nmanagement, is invaluable. Thai emergency physicians work at both levels, emphasizing their\nimportant role in emergency management of any source in a disaster-prone country. We aimed to\ninvestigate Thai emergency physiciansâ?? ability in terms of knowledge and preparedness to manage\npotential emergencies using tabletop simulation exercises. Using an established method for training\ncollaboration, two training courses were arranged for over 50 Thai emergency physicians, who were\ndivided into three teams of prehospital, hospital, and incident command groups. Three scenarios of\na terror attack along with a bomb explosion, riot, and shooting, and high building fire were\npresented, and the participantsâ?? performance was evaluated regarding their preparedness, response\nand gained knowledge. Two senior observers followed the leadership characteristic in particular.\nThai physiciansâ?? perceived ability in command and control, communication, collaboration,\ncoordination, and situation assessment improved in all groups systematically. New perspectives\nand innovative measures were presented by participants, which improved the overall management\non the final day. Tabletop simulation exercise increased the perceived ability, knowledge, and\nattitude of Thai emergency physicians in managing major incidents and disasters. It also enabled\nthem to lead emergency management in a situation when alternative leadership is a necessity as\npart of the concept of a flexible surge capacity response system.
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