摘要This study measured the impact of virtual three-level collaboration(3LC)exercises on participants'per-ceived levels of collaboration,learning,and utility(CLU)at hospitals in the southern region of Saudi Arabia.Our 3LC exercise is a tabletop training tool used to facilitate disaster education and document CLU.This model enables the practitioner to acquire new knowledge and promotes active learning.An English version of the CLU scale,the validated Swedish survey tool,was applied to 100 health-care managers or leaders in various positions at both the operational and tactical levels after conducting the 3LC exercises.The response rate was 100％,although not all questions were answered in some cases.The results show that most participants strongly agreed that the exercises focused on collaboration(r2=0.767)and that they had acquired new knowledge during the exercises.There was a statistically significant association between participation in the collaboration exercises and perceived learning(r2=0.793),as well as between perceived learning and utility(r2=0.811).The collaboration exercises enhance the per-ceived effects of CLU.They also improve the ability of participants to adapt situational strategies to achieve a safer society.Although exercises were conducted virtually,they were well received by the participants and achieved a value M=4.4 CLU score,which opens up new dimensions in collaboration simulation exercises.