Entry-Level Forward Surgical Team Training Is Associated with Increased Confidence of Primary Combat Surgeons

Abstract

Background: In recent years, we have established an entry-level Forward Surgical Team (FST) training program in a Chinese military medical university for the 5th grade undergraduates, who would be deployed to different military medical services as primary combat surgeons. This study aimed to assess the role of this pre-service training in improving their confidence with combat medical skills, after several years since they received the training. Methods: We conducted a nationwide survey of 239 primary combat surgeons who have ever participated in an entry-level FST training program before deployment between June 2016 and June 2020, which was for evaluating on a 5-point Likert scale the benefits of entry-level FST training and conventional surgery training in improving their confidence with combat medical skills.The difference in scores was compared using the student t-test. Significance was considered as P < 0.05. Results: The total score was significantly higher for entry-level FST training than that for conventional surgery training (30.76 ± 4.33 vs. 28.95 ± 4.80, P < 0.001). There was no significant difference between the training for surgical skills confidence scores (18.03 ± 8.04 vs. 17.51 ± 8.30, P = 0.098), but for non-technical skills, the score of entry-level FST training was significantly higher than that of conventional surgery training (12.73 ± 5.39 vs. 11.44 ± 5.62, P < 0.001). The distributions of confidence scores were different under various subgroups by demographics. There were no significant differences in scores between the two training in all specific surgical skill sets except "life-saving surgery" (P = 0.011). Scores of all 4 non-technical skill sets were significantly higher for entry-level FST than those for conventional surgery training (P < 0.05). Conclusions: The training should be considered as an essential strategy to improve confidence in combat medical skills, especially life-saving surgery and non-technical skills, for primary combat surgeons.