Despite intense active surveillance among thousands of hospital employees with >97% annual compliance, tuberculin conversion rates were low, and no cases of active TB were identified during 9 years of follow-up. There was no evidence of transmission of M tuberculosis from infected patients to employees during uncontrolled exposures. Rates of TB in the community were low. These data suggest that rigorous application of the Centers for Disease Control and Prevention guidelines and Occupation Safety and Health Administration regulations for preventing nosocomial TB in pediatric hospitals may be excessive and costly. Special provisions should be made for pediatric hospitals with a proven low risk of transmission of M tuberculosis.

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The American College of Surgeons designates this journal-based activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Of the AMA PRA Category 1 Credit™ listed above, a maximum of 1.00 credit meets the requirements for self-assessment. ObjectivesAfter reading the featured articles published in the Journal of Trauma and Acute Care Surgery, participants should be able to demonstrate increased understanding of the material specific to the article. Objectives for each article are featured at the beginning of each article and online. Test questions are at the end of the article, with a critique and specific location in the article referencing the question topic.

population aged ¼65, the prevalence of a positive IGRA result was between 18% and 37% (95% CI). Conclusions IGRA positivity was found to be lowest in the white British population compared with other ethnic groups. Interestingly, of the UK indigenous white elderly population almost 1/3 are infected with TB (latent or active) highlighting significant disease burden among older age groups. With IGRAs heralded as the more specific and reliable diagnostic test, such results may aid future planning and policy making for the management of TB in the UK.

BACKGROUND Military-civilian partnerships for combat casualty care skills training have mostly focused on traditional, combat surgical team training. We sought to better understand US Special Forces (SF) Medics' training at West Virginia University in Morgantown, West Virginia, a Level 1 trauma center, via assessments of medical knowledge, clinical skills confidence, and technical performance. METHODS Special Forces Medics were evaluated using posttraining medical knowledge tests, procedural skills confidence surveys (using a 5-point Likert scale), and technical skills assessments using fresh perfused cadavers in a simulated combat casualty care environment. Data from these tests, surveys, and assessments were analyzed for 18 consecutive SF medic rotations from the calendar years 2019 through 2021. RESULTS A total of 108 SF Medics' tests, surveys, and assessments were reviewed. These SF Medics had an average of 5.3 years of active military service; however, deployed experience was minimal (73% never deployed). Review of knowledge testing demonstrated a slight increase in mean test score between the precourse (80% ± 14%; range, 50–100%) when compared with the postcourse (82% ± 14%; range, 50–100%). Skills confidence scores increased between courses, specifically within the point of injury care (p = 0.09) and prolonged field care (p < 0.001). Technical skills assessments included cricothyroidotomy, chest tube insertion, and tourniquet placement. CONCLUSION This study provides preliminary evidence supporting military-civilian partnerships at an academic Level 1 trauma center to provide specialty training to SF Medics as demonstrated by increase in medical knowledge and confidence in procedural skills. Additional opportunities exist for the development technical skills assessments. LEVEL OF EVIDENCE Therapeutic/Care Management; Level IV.