Shahroud University of Medical siences Shahroud Journal of Medical Sciences 2423-6594 11 3 2025 09 13 Effect of Game-Based and Simulation-Based Training on Triage Knowledge in Mass Casualty Incidents: A Quasi-Experimental Study among Nurses in Semnan, Iran 17 21 10.22100/sjms.v11i3.1283 eng Nasir Amanat Nursing Care Research Center, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran. nasir23a@hotmail.com Hamed Khosravi Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran. hamed.kh2012@ymail.com Roghiyeh Zabihi Student Research Committee, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran. sayeh1379zabihi@gmail.com Fatemeh Zahra Zaman Nejad Nursing Care Research Center, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran. Helen.ashly9731@gmail.com Shahin Abedini Student Research Committee, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran.. Shahinabedini.ir@gmail.com Mahdi Koeini Student Research Committee, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran. mehdishahi7878@gmail.com 2025 06 15 2025 08 04 Background: Mass casualty incidents involve sending a large number of injured people to hospitals. Mass casualty incidents require efficient triage to prioritize care, and nurses, as the largest healthcare workforce, play a key role in crisis response. This study aimed to evaluate the effect of combined game-based and simulation-based training on improving nurses' triage knowledge in mass casualty incidents in hospitals affiliated with Semnan University of Medical Sciences, Iran. Methods: This quasi-experimental study with a pretest-posttest design involved 55 crisis team nurses from eight hospitals affiliated with Semnan University of Medical Sciences, selected via convenience sampling. Participants completed a pretest, followed by a lecture, game-based training, and simulation with 10 simulated patients. Data were analyzed using the Wilcoxon test in SPSS version 26. Results: The increase from the pre-test mean of 11.87±2.31 to the post-test mean of 15.75±1.65 (P-value<0.001) indicated a significant improvement in nurses' knowledge of triage principles. Conclusions: Game-based and simulation-based training significantly improved nurses’ triage knowledge and enhanced their preparedness for mass casualty incidents. It is recommended that these methods be integrated into nursing education and that follow-up assessments be conducted.