Active Shooter: What Would Health Care Students Do While Caring for Their Patients? Run? Hide? Or Fight?

Disaster Med Public Health Prep. 2020 Apr;14(2):173-177. doi: 10.1017/dmp.2019.67. Epub 2019 Jul 24.


Objective: The aim of this study was to explore the clinical decisions that health care students would make if faced with an active shooter event while providing patient care.

Methods: A cross-sectional study design was used to survey 245 students from 6 different professional programs. Participants read 4 case-based scenarios, selected 1 of 4 actions in a multiple-choice format, and responded to an open-ended question. Demographic questions asked whether participants had been a victim of violence and whether they have taken a certified active shooter course. Statistical analysis included descriptive statistics and chi-square testing.

Results: For each case, most students chose "patient-centric" versus "provider-centric" actions (range: 66%-94% and 4%-17%, respectively). The gender of the patient made no difference in actions. Those who attended a certified active shooter course tended to act with more "provider-centric" concerns than those who did not take such a course.

Conclusion: A significant majority of interprofessional health care students, when presented with specific case-scenarios, declared they would act to protect themselves and their patients during an active shooter event. This "patient-centric" attitude transcends the oversimplified "Run-Hide-Fight" axiom and must be addressed by all health care educational institutions.

Keywords: emergency preparedness; mass casualty incidents; survival; violence; weapons.

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • Cross-Sectional Studies
  • Disaster Planning / methods
  • Female
  • Gun Violence / psychology*
  • Health Personnel / education*
  • Health Personnel / psychology*
  • Humans
  • Male
  • Students / psychology
  • Surveys and Questionnaires
  • Terrorism / psychology*