Trauma Resuscitation Evaluation Times and Correlating Human Patient Simulation Training Differences—What is the Standard?

Bonjour, Timothy J.; Charny, Grigory; Thaxton, Robert E.

doi:10.7205/milmed-d-14-00486

Cited by 9 publications

(8 citation statements)

References 28 publications

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“…[ 19 ] The concept that SBME correctly simulates live patients and the skills learner is therefore translatable was recently supported by work from the US military. [ 20 ] In work similar to ours, trauma evaluations were shown to be accomplished more rapidly and with fewer errors after completion of a mass casualty simulation curriculum. [ 21 ]…”

Section: Discussionmentioning

confidence: 84%

A competency-based simulation curriculum for surgical resident trauma resuscitation skills

Moorman

Capizzani

Feliciano

et al. 2017

Int J Crit Illn Inj Sci

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Background:Evidence-based curricula for nonprocedural simulation training in general surgery are lacking. Residency programs are required to implement simulation training despite this shortcoming. The goal of this project was the development of a simulation curriculum that measurably improves milestone performance and replaces traditional experienced-based training with a competency-based model.Materials and Methods:SimMan 3G® (Laerdal Medical, Wappingers Falls, NY, USA) was utilized for simulation. Needs assessment targeted trauma and shock resuscitation. Scenario design applied deliberate practice methodology. Learner performance data included items such as identification of shock physiology, resuscitation products used, volume delivered, use of resuscitation end-points, and knowledge of massive transfusion. Characteristics essential for a successful program were tabulated.Results:Forty-eight residents in postgraduate year (PGY) 2–5 participated representing 100% of the 48 eligible for the training. Senior residents (PGY 4 and 5) demonstrated near universal improvement. Junior residents (PGY 2 and 3) improved in some areas but showed more skill decay between sessions. Overall, milestone performance improved with each training session, and resident feedback was universally positive.Conclusions:This prototype curriculum improved surgical resident competency in shock resuscitation in a simulated patient care environment. It can be modified to accommodate centers with fewer resources and can be implemented by clinical faculty. The essential characteristics of a successful program are identified.

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Section: Discussionmentioning

confidence: 84%

A competency-based simulation curriculum for surgical resident trauma resuscitation skills

Moorman

Capizzani

Feliciano

et al. 2017

Int J Crit Illn Inj Sci

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“…Along with habituation to stress, team performance was documented by specific metric improvements. Resuscitation time decreased by 10 minutes to an average of 13.91 minutes—approaching the mean evaluation time of 10.33 minutes for a highly experienced trauma team in a level 1 DoD facility 14. This is a significant clinical finding as rapid, effective trauma resuscitations decrease patient morbidity and mortality.…”

Section: Discussionmentioning

confidence: 84%

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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“…Similar to prior years, the most common study populations were medical students (21/75; 28%) and residents (48/75; 64%) . Interestingly, this year only one study addressing medical students was highlighted for excellence, in contrast to prior years.…”

Section: Discussionmentioning

confidence: 92%

“…Three of these studies with an experimental design were highlighted . There was a decline in the number of observational studies (35/75; 47%), compared to 2015 (36/61; 59%), but an increase in the number of studies using survey methodology (19/75; 25%) in 2016 compared to 10 of 61, 16% in 2015, and 0% in 2014. It should be noted that all survey studies in this review drew data from participants from multiple institutions per the predetermined selection criteria.…”

Section: Discussionmentioning

confidence: 99%

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Critical Appraisal of Emergency Medicine Educational Research: The Best Publications of 2016

Dubosh

Jordan

Yarris

et al. 2018

AEM Education and Training

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Objectives: The objectives were to critically appraise the emergency medicine (EM) medical education literature published in 2016 and review the highest-quality quantitative and qualitative studies. Methods: A search of the English language literature in 2016 querying MEDLINE, Scopus, Education ResourcesInformation Center (ERIC), and PsychInfo identified 510 papers related to medical education in EM. Two reviewers independently screened all of the publications using previously established exclusion criteria. The 25 top-scoring quantitative studies based on methodology and all six qualitative studies were scored by all reviewers using selected scoring criteria that have been adapted from previous installments. The top-scoring articles were highlighted and trends in medical education research were described.

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Trauma Resuscitation Evaluation Times and Correlating Human Patient Simulation Training Differences—What is the Standard?

Abstract: TR mean times were similar to the HPS arm subsets demonstrating simulation as an effective educational tool. Effective stepwise approaches, incremental time goals, and superior HPS training can improve patient survivability and improved departmental productivity using TR teams.

Cited by 9 publications

References 28 publications

A competency-based simulation curriculum for surgical resident trauma resuscitation skills

A competency-based simulation curriculum for surgical resident trauma resuscitation skills

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

Critical Appraisal of Emergency Medicine Educational Research: The Best Publications of 2016

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