The Preferred Attributes of a Trauma Team Leader: Evidence From a Discrete Choice Experiment

Mo, David; O’Hara, Nathan N.; Hengel, Ross; Cheong, Alexander; Singhal, Ash

doi:10.1016/j.jsurg.2018.06.021

Cited by 12 publications

(20 citation statements)

References 21 publications

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“…The platform focuses on accurate simulation of patient physiology, as well as correct and timely decision making made by the participant. Thus, it lacks the ability to train communication skills, a robust feature of multidisciplinary, high-fidelity simulation that has been consistently shown to be key in effective trauma team leadership 10,27–29,31–34 . However, before one can communicate what is necessary to lead an effective trauma resuscitation the leader must gain pattern recognition, knowledge and confidence which TVRSim is designed to provide.…”

Section: Discussionmentioning

confidence: 99%

Trauma bay virtual reality—A game changer for ATLS instruction and assessment

Colonna

Robbins

Stefanucci

et al. 2022

J Trauma Acute Care Surg

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BACKGROUND:Medical educational research highlights the need for high-fidelity, multidisciplinary simulation training to teach complex decisionmaking skills, such as those taught in Advanced Trauma Life Support (ATLS). This approach is, however, expensive and timeintensive. Virtual reality (VR) education simulation may improve skill acquisition in a cost-effective and time-sensitive manner.We developed a novel trauma VR simulator (TVRSim) for providers to apply ATLS principles. We hypothesized in this pilot study that TVRSim could differentiate practitioner competency with increasing experience and would be well accepted. METHODS:Providers at a Level I trauma center (acute care surgeons, novice (MS4 & PGY1), junior (PGY2 & 3), senior (PGY4-6) residents) ran a blunt, polytrauma VR code. Ten critical decision points were assessed: intubation, cricothyroidotomy, chest tube, intravenous access, focused abdominal sonography for trauma examination, pelvic binder, activation of massive transfusion protocol, administration of hypertonic saline, hyperventilation and decision to go to the operating room (OR). Learner assessment was based on frequency and time to correct decisions. Participant satisfaction was measured using validated surveys. RESULTS:All 31 providers intubated and obtained intravenous access. Novices and juniors frequently failed at hypertonic saline and hyperventilation decisions. Juniors often failed at cricothyroidotomy (60%) and OR (100%) decisions. Mean time to all decisions except going to the OR was longer for all groups compared to acute care surgeons. Mean number of decisions/min was significantly higher for surgeons and seniors compared to juniors and novices. Mortality was 92.3% for novices, 80% for juniors, 25% for seniors and 0% for the attendings. Participants found TVRSim comfortable, easy to use/interact with/performance enhancing, and helped develop skills and learning. CONCLUSIONS:In this pilot study using a sample of convenience, TVRSim was able to discern decision-making abilities among trainees with increasing experience. All trainees felt that the platform enhanced their performance and facilitated skill acquisition and learning.TVRSim could be a useful adjunct to teach and assess ATLS skills.

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Section: Discussionmentioning

confidence: 99%

Trauma bay virtual reality—A game changer for ATLS instruction and assessment

Colonna

Robbins

Stefanucci

et al. 2022

J Trauma Acute Care Surg

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“…A similar study conducted in Vancouver at the BC Children's Hospital identified traits of trauma team leaders that were valued by members of a pediatric trauma team 14 (attributes valued in trauma team members were not investigated in that study). The attributes valued in trauma team leaders that overlapped in the 2 studies were communication, decisiveness and role clarity.…”

Section: Discussionmentioning

confidence: 99%

What attributes define excellence in a trauma team? A qualitative study

Kassam

Cheong

Evans

et al. 2019

cjs

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What attributes define excellence in a trauma team? A qualitative study Background: Hospital trauma teams consist of a diverse spectrum of health care professionals who work together to deliver quality care. Although the qualities of a wellperforming trauma team are often believed to be self-evident, there is little objective information about the most desirable personal and professional characteristics associated with quality trauma care. The aim of this study was to determine the traits and characteristics deemed of greatest value for a trauma team leader and a trauma team member in the adult trauma care setting. Methods: Semistructured interviews were conducted with trauma team leaders and trauma team members at a tertiary Canadian trauma centre. Standard qualitative research methodology was used. Interviews were recorded, transcribed and analyzed via an inductive analysis approach. Results: Thematic saturation was achieved after 5 interviews, and 6 further interviews were conducted to ensure that a breadth of trauma care disciplines were included. Six attributes were identified to be of greatest value for trauma team leaders: communication, role clarity, experience, anticipation, management and decisiveness. Four attributes were identified to be of greatest value for trauma team members: engagement, efficiency, experience and collaboration. We further characterized the language defining the ranking of performance for each of these attributes. Conclusion: Results of this qualitative study involving an experienced and diverse spectrum of trauma team practitioners provide insight into the characteristics that are critical to establishing a "good" trauma team. These findings can be used to inform future determinations of the quality of trauma teams, the education of trauma practitioners and continuing medical education training and assessment tools. Contexte : Les équipes de traumatologie des hôpitaux sont formées de professionnels de la santé de divers horizons qui travaillent ensemble pour offrir des soins de qualité. Bien que les attributs d'une bonne équipe de traumatologie soient souvent vus comme étant évidents, il existe peu de données objectives sur les caractéristiques personnelles et professionnelles les plus fortement associées à des soins traumatologiques de qua lité. Cette étude avait pour but de déterminer les traits et caractéristiques les plus recherchés chez les chefs et les membres d'équipes de traumatologie pour adultes. Méthodes : Nous avons mené des entrevues semi-structurées auprès de chefs et de membres d'équipes de traumatologie, dans un centre tertiaire de traumatologie canadien. Une méthode de recherche qualitative standard a été utilisée. Les entrevues ont été enregistrées et transcrites, puis analysées selon une approche inductive. Résultats : Le seuil de saturation thématique a été atteint après 5 entrevues, mais nous avons mené 6 entrevues supplémentaires pour garantir une variété dans les disciplines représentées. Six attributs ont été relevés pour les chefs d'équipe de traumatologi...

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“…Medical regulatory bodies recognize team leadership as a core competence for medical learners ( 8 - 10 ). The Accreditation Council for Graduate Medical Education (ACGME) expects junior doctors to work efficiently as a leader in teams as part of its six areas of core competencies ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

Leadership Behaviors in Health Care Action Teams: A Systematized Review

Razavi

Jalili

Sandars

et al. 2022

Med. J. Islam. Republ. Iran

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Background: Effective leadership is critical for the performance of health care teams and their intended outcomes for patient care. Given that team leadership is a modifiable and teachable skill, there is a need for a better understanding of this multidimensional behavior to inform future leadership training for health care action (HCA) teams. This systematized review identifies reported observed leadership behaviors in HCA teams, defined as interdisciplinary teams which complete vital tasks in complex, time-pressured, and dynamic situations. Methods: We searched CINAHL, MEDLINE, Scopus, PsycINFO, and Web of Science for peer-reviewed, English language articles using single and combinations of keywords including leadership, health care action team, and teamwork, individually. We included articles published until June 2021 without any specific beginning date. Results: From 242 records, 13 articles were included in the review. We categorized our findings of team leadership behaviors in HCAs based on an existing framework of three dimensions: transition processes, action processes, and interpersonal skills. The most-reported behaviors for transition processes were encouraging team members’ input, (re)assessing the team’s situation, and confirming team members’ understandings. The action processes dimension consisted of behaviors that included monitoring the progress of the patient, managing resources, asking for help when needed, coaching/supervising, and assisting team members as needed. Finally, closed-loop communication and facilitating team members speaking up behaviors were categorized as interpersonal skills. Conclusion: Although team leadership has been an area of focus in the field of health professions education, little attention has been paid to identifying the observable behaviors of effective team leaders in an HCA team. The study identified several new essential team leadership behaviors that had not been previously described, including seeking feedback, shared decision making, and aspects of interpersonal communication. The findings can inform educators in planning and implementing strategies to enhance HCA team leadership training, with the ultimate potential to improve health care.

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The Preferred Attributes of a Trauma Team Leader: Evidence From a Discrete Choice Experiment

Cited by 12 publications

References 21 publications

Trauma bay virtual reality—A game changer for ATLS instruction and assessment

Trauma bay virtual reality—A game changer for ATLS instruction and assessment

What attributes define excellence in a trauma team? A qualitative study

Leadership Behaviors in Health Care Action Teams: A Systematized Review

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