Advancing the Education of Stop the Bleed: Development of a Perfused Synthetic Cadaver Model

Gupta, Aakanksha; Villegas, Cassandra V.; Rosenberg, Jay; Winchell, Robert J.; Barie, Philip S.; Narayan, Mayur

doi:10.1016/j.jss.2019.06.041

Cited by 10 publications

(5 citation statements)

References 6 publications

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“…The risk of bias was moderate due to the lack of a validated tool to discriminate LTB by learners. Gupta et al (2019) started their education scenario with an LTB simulated with a high fidelity/lowcost synthetic perfused manikin appendage. They assessed that participants gained comfort and insight as to when bleeding was and was not controlled (aka LTB).…”

Section: Resultsmentioning

confidence: 99%

“…Similarly, toward SBEC's recommendation for flow, which may be an initial sign of an LTB, videos or .gifs can illustrate severity of to provide context to volume (Spotnitz et al, 2018). As seen in Gupta et al (2019), flow and pulsatility can effectively be communicated through models. Having this reference may be amenable to situations/circumstances where volume estimation through calculation might be prohibitive (ex., violence, number of injured persons, etc.).…”

Section: Discussionmentioning

confidence: 99%

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Systematic review of lay responders educational outcomes to identify life-threatening bleeding

Pellegrino¹,

Smith²,

Banton³

et al. 2021

IJFAE

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Pellegrino, et al. 2021 Creative Commons Attribution-NonCommercial 4.0 International License Objective: Identify evidence of how lay responders can accurately identify life-threatening bleeding (LTB) from educational interventions. Method: A systematic review process of the PubMed database to identify experimental and observational studies of educational interventions to identify LTB by lay responders. No exclusion regarding timeframe.Abstracts needed to be in English.Results: Three studies were identified, two with moderate risk of bias due to non-validation of measurement tool and one with a high risk of bias. All studies contributed to a notion that lay responders could identify a gross characteristic of LTB when presented visually.Implications: A gap exists in evidence to suggest lay responders can accurately distinguish LTB from non-LTB in the field or with distractions (e.g., clothing, porous surfaces). A valid means of measuring this learning outcomes would allow for future research to be reviewed and for meta-analysis for educational purposes to distinguish quality within and between programs. Secondarily, it may serve as a proxy for survival behaviors in the field, as application of tourniquets is still rare. Educationally, multiple representations of LTB in a localized context can be used (online or face-to-face) to raise awareness of characteristics of LTB for future identification.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Systematic review of lay responders educational outcomes to identify life-threatening bleeding

Pellegrino¹,

Smith²,

Banton³

et al. 2021

IJFAE

View full text Add to dashboard Cite

show abstract

“…The perfused cadaveric model simulation method, which was introduced to improve the level realism in anatomical approach and professional skills training, has been implemented in various fields of care, including advanced surgical skills, endovascular procedures, and complex and critical scenarios [4,5,7,8,[10][11][12][13][14][15][16][17][18][19][20][21]. The achievement of hemostasis in military tourniquet training obtained using the perfused cadaveric model was superior to that obtained from other tourniquet training techniques [22].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of a perfused cadaver model for simulated trauma resuscitation in advanced surgical skills training

et al. 2022

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Background To develop a perfused cadaveric model for trauma surgery simulation, and to evaluate its efficacy in trauma resuscitation advanced surgical skills training. Methods Fourteen fourth-year general surgery residents attended this workshop at Siriraj Hospital (Bangkok, Thailand). Inflow and outflow cannulae and a cardiopulmonary bypass pump were used to create the perfusion circuit. Inflow was achieved by cannulating the right common carotid artery, and outflow by cannulation of both the right common femoral artery and the internal jugular vein. Arterial line monitoring was used to monitor resuscitation response and to control perfusion pressure. The perfusion solution comprised saline solution mixed 1:1 with glycerol (50%) and water with red food dye added. Advanced surgical skills during life-threatening injuries and damage control resuscitation operations were practiced starting from the airway to the neck, chest, peripheral vessels, abdomen, and pelvis. Resuscitative endovascular balloon occlusion of the aorta (REBOA) was also practiced. Post-workshop survey questions were grouped into three categories, including comparison with previous training methods; the realism of anatomical correlation and procedures; and, satisfaction, safety, and confidence. All questions and tasks were discussed among all members of the development team, and were agreed upon by at least 90% of experts from each participating medical specialty/subspecialty. Results The results of the three main groups of post-workshop survey questions are, as follows: (1) How the training compared with previous surgical training methods—mean score: 4.26/5.00, high score: 4.73/5.00; (2) Realism of anatomical correlation and procedures—mean score: 4.03/5.00, high score: 4.60/5.00; and, (3) Satisfaction, safety, and confidence—mean score: 4.24/5.00, high score: 4.47/5.00. Conclusion The developed perfused cadaveric model demonstrated potential advantages over previously employed conventional surgical training techniques for teaching vascular surgery at our center as evidenced by the improvement in the satisfaction scores from students attending perfused cadaveric training compared to the scores reported by students who attended earlier training sessions that employed other training techniques. Areas of improvement included ‘a more realistic training experience’ and ‘improved facilitation of decision-making and damage control practice during trauma surgery’.

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“…A questionnaire was conducted before and after the course (see Additional le 1 and Additional le 2) to evaluate the effect of traditional teaching in both the control group and experimental group. The competencies needed for medical students in terms of speci c standards were established on the basis of the latest International Medical Association guidelines and other relative studies [18][19][20][21][22][23][24] .…”

Section: Study Protocolmentioning

confidence: 99%

PTEBL Teaching Method Combined with Caesar (Trauma Patient Simulator) Versus Traditional Teaching Method in The Training of Outstanding Doctoral Candidates in STB Skills: A Randomized Controlled Trial

Chen

DiNenna

et al. 2021

Preprint

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Background: The “Stop The Bleed” (STB) campaign has achieved remarkable results since it launched in 2016, but there is no report on the application of a STB course combined with a trauma patient simulator. This study proposes the “problem-, team-, and evidence-based learning” (PTEBL) teaching method combined with Caesar (trauma patient simulator) based on the STB course, and compares its effect with the traditional teaching method in outstanding doctoral candidates training of hemostasis skills.Method: Seventy-eight outstanding doctoral candidates program students (five-years and eight-years) were selected as the research subjects and were randomly divided into a control group (traditional teaching method, n=34) and an experimental group (PTEBL teaching method combined with Caesar, n=44). Their confidence of hemostasis skills and willingness to rescue were investigated before and after the course in both groups.Result: Students’ self-confidence of STB skills and willingness to rescue in both groups were improved after the class. Compared with the control group, students in the experimental group were more confident in compressing with bandages and compressing with a tourniquet after a class (compressing with bandages: control group 3.9±0.8 vs. experimental group 4.3±0.7, P=0.014; compressing with a tourniquet: control group 3.9±0.4 vs. experimental group 4.5±0.8, P=0.001) More students in the experimental group than the control group thought that the use of Caesar for scenario simulation could improve learning (control group 55.9% vs. experimental group 81.8%, P=0.024), and showed higher teacher-student interaction (control group 85.3% vs. experimental group 97.7%, P=0.042) The overall effectiveness of the teaching was better in the experimental group than the control group (control group 85.3% vs. experimental group 97.7%, P=0.042). There was a significant positive correlation between teacher-students interaction and overall effectiveness of teaching (R=1.000; 95%CI, 1.000-1.000; P<0.001).Conclusion: The PTEBL teaching method combined with Caesar can effectively improve students' mastery of STB skills, and overcome the shortcomings of traditional teaching methods, which has a certain promotional value in the training of outstanding doctoral candidates in STB skills.

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Advancing the Education of Stop the Bleed: Development of a Perfused Synthetic Cadaver Model

Cited by 10 publications

References 6 publications

Systematic review of lay responders educational outcomes to identify life-threatening bleeding

Systematic review of lay responders educational outcomes to identify life-threatening bleeding

Efficacy of a perfused cadaver model for simulated trauma resuscitation in advanced surgical skills training

PTEBL Teaching Method Combined with Caesar (Trauma Patient Simulator) Versus Traditional Teaching Method in The Training of Outstanding Doctoral Candidates in STB Skills: A Randomized Controlled Trial

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