In order to better align to the real-world evacuation process and understand the dynamics of the evacuees in time scale, it is expected that recent experimental studies on how walking speed and coefficient of flow rate changed can be built in this model in the foreseeable future.

The use of the multi-objective optimization allows for the evaluation of each and every possible solution to both sets of criteria, i.e. individual risks and time costs. Furthermore, the use of Pareto optimal set approach avoids subjective judgments and value trade-offs until the very late stage of the optimization procedure. Major subsets of the optimum solution may be discarded without much debate among stakeholders (for example, solutions implying higher risk with minimal decrease in travel time).

a review process after a simulationIncreased accuracy through holistic approach to projectsJoined-up; improved coherency; greater transparencyMore efficient and effective use of resourcesCommon understanding of issues; enhanced decision makingBetter understanding by non- experts

Many constraints for the algorithm to workWorks in specific context only

There may be other models of communication and teamwork education that are also effective. Using self-report to evaluate transfer of training to the real domain has inherent limitations (e.g. learned tend to overestimate their performance and over attribute their improvements to the course).The use of self-reports to evaluate courses is a relatively weak measure of effectiveness compared with other forms of testing.

Limitation of the model are described (p31) e.g. a realistic case study that incorporates a simulation model would be a useful future research project

Training interventions appear to be successful but references to gaining information via training and education did not include sharing or developing others either from a lack of means or motivation.Performance improvement was hard to assess.Greater attention should be paid to the front-end of training, not just computing the economic value or benefit of training, but ensuring true value-added by developing a shared understanding and identification with the organisational goals and working out a strategy to manage their achievement through appropriate boundary objects (e.g. benefits realisation maps and balanced scorecards).

It is difficult to predict long-term outcomes from a cross-sectionaldesign. Further, our study sample was limited to one convenient troop and does not represent the entire JGSDF or all disaster workers.

The results of this review provide an evidence base for public health practitioners responsible for enhancing key components of preparedness and response such as communication, training and planning effortsResearch gaps remain, in particular in the area of information sharing, communication to the public, and the development of criteria and metricsThe authors acknowledge that the literature search strategy, adopted from a previous study to allow comparisons over time, may lack specificity in this field.This synthesis does not include articles related to research areas that were not considered a priority by the 2008 IOM letter report, limiting the findings to this niche of research.The authors recognize that results from systematic reviews can direct and influence the development of future research agendas in a meaningful way only when well integrated with input from practitioners on what knowledge production is most needed to address practice questions. As well as on the best ways to disseminate existing knowledge that does not reach practitioners. Thus, this review should be considered only a first step in this direction.Future steps will consist in combining these results with feedback from practitioners engaged in preparedness efforts.

When managed effectively, emergencies may present an opportunity for professional growth and a sense of unity for those involved.