Teams managing civilian and military complex trauma: What are the competencies required in austere environments and the potential of simulation technology to address them?

Abstract

Surgical training in civilian hospitals may not be sufficient for managing complex trauma in a setting where such care is not commonly practiced. Understanding the challenges that civilian teams face when moving to austere environments can inform the competencies that need to be trained. The aim of this study was to explore the competencies required in austere environments for teams managing complex trauma, and how they can be trained with simulation technologies. Ethnographic field observations were conducted, and field notes were synthesized. The field notes were structured with the elements of Activity Theory to generate the teams’ competencies that need to be trained. A literature review was conducted to verify the results and identify examples of relevant simulation modalities. The analysis resulted in a structured list of competencies for civilian teams to manage complex trauma in an austere environment and recommendations which simulation technologies could be used in training of those competencies based on published studies. Our study contributes to understanding the challenges that civilian teams face when operating in an austere environment. A systematized list of competencies with suggested simulation technologies directs future research to improve quality of complex trauma training in civilian and military collaboration.

Red line the red line: Optimizing emergency medicine physicians and surgeons collaborative roles on trauma teams

“…24 Team members may find themselves working with unfamiliar equipment, personnel or infrastructure. 24 Despite all these challenges overlaid on a high stakes environment, clinicians must be able to assimilate data to gain situational awareness, which is the anchor for most cognitive and interpersonal competencies for management of trauma patients. 25 The red line culture was the antithesis of an environment which fostered situational awareness.…”

“…Multidisciplinary simulation laboratories for trauma resuscitation with an emphasis on team performance and NTS can build on teamwork concepts that are introduced in ATLS. 24,[29][30][31] Monthly multidisciplinary trauma conferences and video case reviews of trauma resuscitation led by EPs and trauma surgeons could use previous cases to create simulation scenarios that provide formative learning for technical and NTS. 5) Include EPs in trauma focused surgical courses.…”

Self-perceived preparedness and training needs of healthcare personnel on humanitarian mission: a pre- and post-deployment survey

“…Third, medical professionals’ background in training and experience should be considered during the composition of medical teams for deployment, ensuring a representation of complementary skills. Competency lists have been established for deployed teams providing damage control surgery in austere environments [ 9 , 47 ], and an essential addition was made by Stathakarou et al ., who included nontechnical competencies [ 48 ]. Application of a competency checklist before deployment facilitates identifying the need for additional customised training or simultaneous deployment of medical professionals with complementary skills.…”

Game Elements in the Design of Simulations in Military Trauma Management Training: Protocol for a Systematic Review

“…We will include both qualitative and quantitative empirical and design studies that address different types of simulation interventions, identified in our previous study [ 10 ], which incorporate game elements. Game elements will be identified using published gamification frameworks [ 14 , 16 ].…”

“…Different simulation technologies can be used to train different competencies in trauma [ 9 ]. A previous study [ 10 ] identified examples of emerging technologies used for trauma training that have the potential to support the education and training toward challenges that civilian trauma teams face when moving to an austere environment. Examples included virtual reality, virtual reality combined with haptics and manikins or requiring special equipment, virtual patients, and gamification.…”