• Surgery · Oct 2021

    Multidisciplinary simulation-based trauma team training with an emphasis on crisis resource management improves residents' non-technical skills.

    • Elizabeth M Huffman, Nick E Anton, Dimitrios I Athanasiadis, Rami Ahmed, Dylan Cooper, Dimitrios Stefanidis, and Nicole Kissane Lee.
    • Department of Surgery, Indiana University School of Medicine, Indianapolis, IN. Electronic address: https://twitter.com/BetsyHuffmanMD.
    • Surgery. 2021 Oct 1; 170 (4): 1083-1086.

    BackgroundNon-technical skills impact trauma resuscitation time. Crisis resource management teaches non-technical skills required for effective teamwork in a crisis. We developed a simulation-based multidisciplinary trauma team training, with an emphasis on crisis resource management and a goal of improving residents' non-technical skills.MethodsTwenty-five post-graduate year-1 general surgery and emergency medicine residents were divided into multidisciplinary teams with embedded nurse participants. Teams underwent 3 trauma resuscitation scenarios followed by a crisis resource management debrief. Additionally, a Just-In-Time crisis resource management didactic was delivered before 1 scenario. Teams' non-technical skills in each scenario were assessed by expert raters using non-technical skills scale for trauma and scenario scores before and after the Just-In-Time didactic were compared. Multiple linear-regression calculating the impact of clinical scenario, case order, and timing relative to the Just-In-Time didactic on a teams' non-technical skills scale for trauma score was performed.ResultsSeventy-four team T-NOTECHS ratings were completed. T-NOTECHS total score was significantly higher on the third training case regardless of clinical scenario or timing relative to the Just-In-Time didactic (pre = 15.58 vs post = 18.11, P = .117). Teams scored an average of 15.44 on the first scenario of the day, 16.63 on the second, and 19.04 on the last (P < .001).ConclusionCrisis resource management-focused multidisciplinary team training significantly improves residents' non-technical skills in the simulated environment. Case repetition followed by crisis resource management focused debriefings outweighed the effect of a single Just-In-Time crisis resource management didactic.Copyright © 2021 Elsevier Inc. All rights reserved.

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