Abstract
INTRODUCTION: Design, implementation, and evaluation of prehospital exercises are some of the important steps to prepare and deploy natural disaster risk management programs, particularly concerning earthquake hazards. This study aimed to identify and provide valid operational indicators and components that can be utilized in the management and assessment of prehospital preparedness exercises in earthquakes. METHOD: A qualitative conventional content analysis constituted the methodological approach for this study. Data were systematically gathered through in-depth, semistructured interviews with 11 paramedic nurses that were purposefully selected based on their demonstrated expertise in prehospital exercise management. Data analysis was done in five steps based on Granheim and Lundman's approach, and for the trustworthiness of the data, this study used Lincoln and Guba's recommendations. RESULT: After multiple rounds of analyzing and summarizing the data and taking into consideration similarities and differences, 375 initial codes, 12 subcategories, and 3 main categories were created based on the results of data analysis. The main categories included (A) "Strategic Organization of the Exercise"; (B) "Empowerment and Self-Efficacy Enhancement of Exercise Personnel"; and (C) "Improvement and Development of Effective Exercise Drivers." CONCLUSION: This research establishes a crucial knowledge framework that empowers exercise planners in prehospital settings to design scientifically sound and standardized exercises aimed at enhancing disaster response processes. The primary finding is that the successful implementation and evaluation of both discussion-based and operation-based exercises, when informed by these identified quality indicators, significantly fosters knowledge development and promotes essential behavioral change among prehospital paramedic nurses, thereby facilitating a standardized emergency response.