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

Abstract

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.

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

“…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).…”

Application of technology to educational needs in surgery

“…The technology resides in the simulator which can demonstrate cardiovascular and respiratory physiologic changes and permit selected interventions, such as airway management. Successful use in surgical residency is well established 27 and competency‐based training models for residents have also been described 28 . Surgical trainees in trauma teams have particularly benefited from participation in patient simulation where specific roles, team interactions, and protocols are critical to management 29 .…”

The state of emergency preparedness and disaster management response education and training in American medical schools: Preparing the future generations of medical professionals

“…Third, this lack of learning opportunities points towards an underutilization of resources. The literature demonstrates that early medical student training significantly improves both self-confidence and actual performance in healthcare settings in a variety of settings [ [7] , [8] , [9] , [10] ]. In particular, simulation has been increasingly implemented in trauma settings, in both civilian and military scenarios [ 11 , 12 ].…”