Hyper-Realistic, Team-Centered Fleet Surgical Team Training Provides Sustained Improvements in Performance

Hoang, Tuan; Kang, Jeff; Siriratsivawong, Kris; LaPorta, Anthony J.; Heck, Amber; Ferraro, Jessica; Robinson, Douglas H.; Walsh, Jonathan

doi:10.1016/j.jsurg.2016.03.004

Cited by 19 publications

(18 citation statements)

References 6 publications

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“…Four studies developed training programs that simulated a crisis requiring operative care as part of the intervention. 20 21 22 23 One study simulated an operative emergency occurring during active deployment in Iraq. 23 One study simulated an operative emergency on a Navy Shipboard as a part of pre-deployment training.…”

Section: Resultsmentioning

confidence: 99%

“… 23 One study simulated an operative emergency on a Navy Shipboard as a part of pre-deployment training. 21 The remaining two studies developed interventions that simulated crises occurring during ongoing operations. 20 22 One study simulated an intraoperative code during general surgery, 20 and another study simulated an intraoperative code during robotic surgery, while the robot was actively docked.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies included a didactic and simulation component, while one study included only a simulation component. 20 21 23 One of the four studies evaluated the sustainability of the training after 5 months. 21 The operating room subgroup had the largest proportion of studies that assessed technical skills only (three of four studies).…”

Section: Resultsmentioning

confidence: 99%

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The Role of High-Fidelity Team-Based Simulation in Acute Care Settings: A Systematic Review

Armenia

Thangamathesvaran

Caine

et al. 2018

Surg J

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Introduction High-fidelity team-based simulation has been identified as an effective way of teaching and evaluating both technical and nontechnical skills. Several studies have described the benefits of this modality in a variety of acute care settings, but a lack of standardized methodologies has resulted in heterogeneous findings. Few studies have characterized high fidelity simulation across a broad range of acute care settings and integrated the latest evidence on its educational and patient impact. Methods The MEDLINE, EMBASE, Cochrane Library, and PsycINFO databases were searched for empirical studies from the last 10 years, investigating high fidelity team-based simulation in surgical, trauma, and critical care training curricula. Results Seventeen studies were included. Interventions and evaluations were comprehensively characterized for each study and were discussed in the context of four overarching acute care settings: the emergency department/trauma bay, the operating room, the intensive care unit, and inpatient ad hoc resuscitation teams. Conclusions The use of high-fidelity team-based simulation has expanded in acute care and is feasible and effective in a wide variety of specialized acute settings, including the emergency department/trauma bay, the operating room, the intensive care unit, and inpatient ad hoc resuscitation teams. Training programs have evolved to emphasize team-based, multidisciplinary education models and are often conducted in situ to maximize authenticity. In situ simulations have also provided the opportunity for system-level improvement and discussions of complex topics such as social hierarchy. There is limited evidence supporting the impact of simulation on patient outcomes, sustainability of simulation efforts, or cost-effectiveness of training programs. These areas warrant further research now that the scope of utilization across acute care settings has been characterized.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The Role of High-Fidelity Team-Based Simulation in Acute Care Settings: A Systematic Review

Armenia

Thangamathesvaran

Caine

et al. 2018

Surg J

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“…As with salivary cortisol, the authors think that data imply potential habituation of the sAA stress response with repeated exposure, implying possible stress adaptation. Laporta and Hoang have shown somewhat similar results for salivary cortisol and α-amylase changes on medical student trainees undergoing hyper-realistic training 2–4…”

Section: Discussionmentioning

confidence: 85%

“…The first simulation scenario was repeated on the last training day six to evaluate performance changes. The authors have previously reported smaller studies on hyper-realistic simulation surgical training of US Military providers 2–4. This study was conducted using an on-site hyper-realistic training simulation environment provided by Strategic Operations (STOPS), San Diego.…”

Section: Methodsmentioning

confidence: 99%

Hyper-realistic and immersive surgical simulation training environment will improve team performance

Hoang¹,

LaPorta

Malone

et al. 2020

Trauma Surg Acute Care Open

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BackgroundSurgical trauma care requires excellent multidisciplinary team skills and communication to ensure the highest patient survival rate. This study investigated the effects of Hyper-realistic immersive surgical team training to improve individual and team performance. A Hyper-realistic surgical training environment is defined as having a high degree of fidelity in the replication of battlefield conditions in a training environment, so participants willingly suspend disbelief that they become totally immersed and eventually stress inoculated in a way that can be measured physiologically.MethodsSix multispecialty member US Navy Fleet Surgical/US Army Forward Surgical Teams (total n=99 evaluations) underwent a 6-day surgical training simulation using movie industry special effects and role players wearing the Human Worn Surgical Simulator (Cut Suit). The teams were immersed in trauma care scenarios requiring multiple complex interventions and decision making in a realistic, fast-paced, intensive combat trauma environment.ResultsHyper-realistic immersive simulation training enhanced performance between multidisciplinary healthcare team members. Key efficacy quantitative measurements for the same simulation presented on day 1 compared with day 6 showed a reduction in resuscitation time from 24 minutes to 14 minutes and critical error decrease from 5 to 1. Written test scores improved an average of 21% (Medical Doctors 11%, Registered Nurses 25%, and Corpsman/Medics 26%). Longitudinal psychometric survey results showed statistically significant increases in unit readiness (17%), combat readiness (12%), leadership quality (7%), vertical cohesion (7%), unit cohesion (5%), and team communication (3%). An analysis of salivary cortisol and amylase physiologic biomarkers indicated an adaptive response to the realistic environment and a reduction in overall team stress during performance evaluations.ConclusionsHyper-realistic immersive simulation training scenarios can be a basis for improved military and civilian trauma training.Level of evidenceLevel III.

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Simulation in Defense and Combat Medicine

Park

Baker

Pollock

et al. 2021

Comprehensive Healthcare Simulation: Emergency Medicine

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Hyper-Realistic, Team-Centered Fleet Surgical Team Training Provides Sustained Improvements in Performance

Cited by 19 publications

References 6 publications

The Role of High-Fidelity Team-Based Simulation in Acute Care Settings: A Systematic Review

The Role of High-Fidelity Team-Based Simulation in Acute Care Settings: A Systematic Review

Hyper-realistic and immersive surgical simulation training environment will improve team performance

Simulation in Defense and Combat Medicine

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