A Shared Ethos: The Military Health System Strategic Partnership with the American College of Surgeons

Knudson, M. Margaret; Elster, Eric A.; Woodson, Jonathan; Kirk, Garrett G.; Turner, Patricia L.; Hoyt, David B.

doi:10.1016/j.jamcollsurg.2016.03.006

Cited by 27 publications

(13 citation statements)

References 12 publications

(10 reference statements)

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“…TS-MCPs are now supported by law to increase military trauma care readiness 3. As the DoD enters into partnerships with civilian trauma centers having practical prediction models to assess the “readiness value” of TS-MCP is imperative and objective measurements are a starting point for this determination 4 5. Predictable educational experiences facilitate planning, expectation management and help inform/establish the goals of the trauma skills sustainment training.…”

Section: Discussionmentioning

confidence: 99%

Validation of a predictive model for operative trauma experience to facilitate selection of trauma sustainment military–civilian partnerships

Hall

Qureshi²,

Glaser³

et al. 2019

Trauma Surg Acute Care Open

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BackgroundTrauma readiness is a Department of Defense requirement for military healthcare providers. Surgeons must maintain readiness to optimize surgical care on the battlefield and minimize preventable death. The objective of this study was to validate a predictive model for trauma operative exposure by applying the model prospectively.MethodsThe predictive model for operative trauma exposure was prospectively applied to predict the number of emergent operative cases that would be experienced over predetermined time periods at four separate trauma sustainment military–civilian partnerships (TS-MCP). Notional courses were designed to be 2 or 4 weeks long and consisting of 5 and 12 overnight call periods, respectively. A total of 51 separate 2-week courses and 49 4-week courses were evaluated using the model. The outcome measure was the number of urgent (occurring within a day of arrival) operative trauma cases.ResultsTrauma/general surgery case volumes during call periods of notional courses were within the predicted range at least 98% of the time. Orthopedic volumes were more variable with a range of 82%–98% meeting expectation depending on the course length and institution.ConclusionThe previously defined model accurately predicted the number of urgent trauma/general surgery cases course participants would likely experience when applied prospectively to TS-MCP; however, the model was less accurate in predicting acute orthopedic trauma exposure. While it remains unknown how many cases need to be performed meet a trauma sustainment requirement, having a model with a predictive capability for case volume will facilitate metric development. This model may be useful when planning for future TS-MCP.Level of evidenceEconomic and Value Based Evaluations Level II

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Section: Discussionmentioning

confidence: 99%

Validation of a predictive model for operative trauma experience to facilitate selection of trauma sustainment military–civilian partnerships

Hall

Qureshi²,

Glaser³

et al. 2019

Trauma Surg Acute Care Open

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show abstract

“…The program delineated a blueprint specifying the practice domain of general surgery; inclusive of performance metrics across the professional domains of cognition (Knowledge), psychomotor skills (Skills), and integrated abilities in applied practice (Abilities). 25,26 Collectively referred to as KSAs, these requisite performance attributes were identified through consensus and Angoff processes involving hundreds of military and civilian surgeons in all sub-specialties. 27 Precise measurement systems with rigorous psychometric characteristics were developed to facilitate integration of data from multiple inputs for general surgery, as well as for an extensive array of surgical sub-specialties.…”

Section: Performance Data and Ai Developmentmentioning

confidence: 99%

Challenges and opportunities for artificial intelligence in surgery

Andreatta

Smith

Graybill

et al. 2021

Journal of Defense Modeling & Simulation

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Surgery is an exceptionally complex domain where multi-dimensional expertise is developed over an extended period of time, and mastery is maintained only through ongoing engagement in surgical contexts. Expert surgeons integrate perceptual information through both conscious and subconscious awareness, and respond to the environment by leveraging their deep understanding of surgical constructs. However, their ability to utilize these deep knowledge structures can be complicated by continuous advances in technology, medical science, pharmacology, technique, materials, operative environments, etc. that must be routinely accommodated in professional practice. The demands on surgeons to perform perfectly in ever-changing contexts increases cognitive load, which could be reduced through judicious use of accurate and reliable artificial intelligence (AI) systems. AI has great potential to support human performance in complex environments such as surgery; however, the foundational requirements for the rules governing algorithmic development of performance requirements necessitate the active involvement of surgeons to precisely model the quantitative measures of performance along the continuum of expertise. Providing the AI development community with these data will help assure that accurate and reliable systems are designed to supplement human performance in applied surgical contexts. The Military Health System’s Clinical Readiness Program is developing these types of metrics to support military medical readiness.

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“…With this in mind, Drs Hoyt, Rich, Woodson, and Elster created the Military Health System Strategic Partnership with the American College of Surgeons (MHSSPACS), with an agreement signed at this very meeting 5 years ago. 17 The goals of this partnership are to share information in the following 4 areas: trauma systems, trauma education and training, trauma/surgical quality, and trauma research.…”

Section: Punctuated Equilibrium Theory and The Military Health Systemmentioning

confidence: 99%

A Perfect Storm: 2019 Scudder Oration on Trauma

Knudson

2020

Journal of the American College of Surgeons

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A Shared Ethos: The Military Health System Strategic Partnership with the American College of Surgeons

Cited by 27 publications

References 12 publications

Validation of a predictive model for operative trauma experience to facilitate selection of trauma sustainment military–civilian partnerships

Validation of a predictive model for operative trauma experience to facilitate selection of trauma sustainment military–civilian partnerships

Challenges and opportunities for artificial intelligence in surgery

A Perfect Storm: 2019 Scudder Oration on Trauma

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