Objective Military Trauma Team Performance Improvement from Military-Civilian Partnerships

Hall, Maj Andrew; Boecker, Maj Felix; Englert, M; Hanseman, Dennis J.; Fields, Maj Adrienne

doi:10.1177/000313481808401220

Cited by 10 publications

(9 citation statements)

References 4 publications

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“…Generally, subjects felt that the simulation and clinical aspects of the training were beneficial and improved their perceived ability to function in a team, confidence in their ability to perform field trauma care, team communication and combat trauma knowledge 30–32,40,43 . As training progressed, team efficiency improved, based on time to completion of the primary survey of 15 different teams 49 . However, predeployment clinical experiences through just-in-time MCP are variable.…”

Section: Resultsmentioning

confidence: 99%

Integrated military and civilian partnerships are necessary for effective trauma-related training and skills sustainment during the inter-war period

Lee

Hall

Carr

et al. 2021

J Trauma Acute Care Surg

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Section: Resultsmentioning

confidence: 99%

Integrated military and civilian partnerships are necessary for effective trauma-related training and skills sustainment during the inter-war period

Lee

Hall

Carr

et al. 2021

J Trauma Acute Care Surg

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“…Various modalities exist, including increased fidelity and virtual reality simulations (Kalun et al, 2018; Murphy et al, 2018), although there are still shortcomings, such as lack of realism, authenticity, and are often participated out of context in a different environment (Quick, 2018). Simulation education can build on these modalities and improve learner confidence and self-efficacy (Miyasaka et al, 2015; Popp et al, 2012) with improved technique (Hall et al, 2018; Moorman et al, 2017). In some educational programs, simulation may lead to superior training outcomes compared with conventional surgery training (Zevin et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Monthly Trauma Training and Simulation Are Associated With Improved Resident Skill and Leadership

Park¹,

Lin²,

Grant³

et al. 2022

Journal of Trauma Nursing

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BACKGROUND: Training for trauma procedures has been limited to infrequent courses with little data on longitudinal performance, and few address procedural and leadership skills with granular assessment. We implemented a novel training program that emphasized an assessment of trauma resuscitation and procedural skills. OBJECTIVE: This study aimed to determine whether this program could demonstrate improvement in both skill sets in surgical trainees over time. METHODS: This was a prospective, observational study at a Level I trauma center between November 2018 and May 2019. A procedural skill and simulation program was implemented to train and evaluate postgraduate year (PGY) 1–5 residents. All residents participated in an initial course on procedures such as tube thoracostomy and vascular access, followed by a final evaluation. Skills were assessed by the Likert scale (1–5, 5 noting mastery). PGY 3s and above were additionally evaluated on resuscitation. A paired t test was performed on repeat learners. RESULTS: A total of 40 residents participated in the structured procedural skills and simulation program. Following completion of the program, PGY-2 scores increased from a Mdn [interquartile range, IQR] 3.0 [2.5–4.0] to 4.5 [4.2–4.5]. The PGY-3 scores increased from a Mdn [IQR] 3.95 [3.7–4.6] to 4.8 [4.6–5.0]. Eighteen residents underwent repeat simulation training, with Mdn [IQR] score increases in PGY 2s (3.7 [2.5–4.0] to end score 4.47 [4.0–4.5], p = .03) and PGY 3s (3.95 [3.7–4.6] to end score 4.81 [4.68–5.0], p = .04). Specific procedural and leadership skills also increased over time.

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“…21,22 Simulation also likely improves team functionality in terms of team efficiency and performance of technical skills. 23 Simulations performed regularly when deployed should maintain some team skills, but are likely inadequate for surgeon specific procedural and resuscitative skills. Simulation capabilities have not been well studied in surgeons, and the skill transfer effectiveness is unknown, especially in already trained personnel.…”

Section: Discussionmentioning

confidence: 99%

“…Simulation is certainly beneficial for the surgical team, in terms of equipment familiarization and team dynamics by developing open and effective communication, team trust and accountability, and dynamic subordination and fluid leadership skills for each team member 21,22 . Simulation also likely improves team functionality in terms of team efficiency and performance of technical skills 23 . Simulations performed regularly when deployed should maintain some team skills, but are likely inadequate for surgeon specific procedural and resuscitative skills.…”

Section: Discussionmentioning

confidence: 99%

Military deployment’s impact on the surgeon’s practice

Hall

Qureshi

Vasquez

et al. 2021

J Trauma Acute Care Surg

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BACKGROUND:As the United States withdraws from overseas conflicts, general surgeons remain deployed in support of global operations. Surgeons and surgical teams are foundational to combat casualty care; however, currently, there are few casualty producing events.Low surgical volume and acuity can have detrimental effects on surgical readiness for those frequently deployed. The surgical team cycle of deployment involves predeployment training, drawdown of clinical practice, deployment, postdeployment reintegration, and rebuilding of a patient panel. This study aims to assess these effects on typical general surgeon practices. Quantifying the overall impact of deployment may help refine and implement measures to mitigate the effects on skill retention and patient care. METHODS:Surgeon case logs of eligible surgeons deploying between January 1, 2017, and January 1, 2020, were included from participating military treatment facilities. Eligible surgeons were surgeons whose case logs were primarily at a single military treatment facility 26 weeks before and after deployment and whose deployment duration, location, and number of deployed cases were obtainable. RESULTS:Starting 26 weeks prior to deployment, analyzing in 1-week intervals toward deployment time, case count decreased by 4.8% (p < 0.0001). With each 1-week interval, postdeployment up to the 26-week mark, case count increased by 6% (p < 0.0001). Cases volumes most prominently drop 3 weeks prior to deployment and do not reach normal levels until approximately 7 weeks postdeployment. Case volumes were similar across service branches. CONCLUSION:There is a significant decrease in the number of cases performed before deployment and increase after return regardless of military branch. The perideployment surgical volume decline should be understood and mitigated appropriately; predeployment training, surgical skill retention, and measures to safely reintegrate surgeons back into their practice should be further developed and implemented.

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Objective Military Trauma Team Performance Improvement from Military-Civilian Partnerships

Cited by 10 publications

References 4 publications

Integrated military and civilian partnerships are necessary for effective trauma-related training and skills sustainment during the inter-war period

Integrated military and civilian partnerships are necessary for effective trauma-related training and skills sustainment during the inter-war period

Monthly Trauma Training and Simulation Are Associated With Improved Resident Skill and Leadership

Military deployment’s impact on the surgeon’s practice

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