Trauma Boot Camp: A Simulation-Based Pilot Study

Abstract

Introduction: Interns are often unprepared to effectively communicate in the acute trauma setting. Despite the many strengths of the Advanced Trauma Life Support (ATLS) program, the main shortcoming within the course is the deficiency of teamwork and leadership training. In this study, we describe the creation of an interdisciplinary boot camp in which interns' basic trauma knowledge, level of confidence, and teamwork skills are assessed.Methods: We designed a one-day, boot camp curriculum for interns of various specialties with the purpose of improving communication and teamwork skills for effective management of acute trauma patients. Our curriculum consisted of a one-day, twelve-hour experience, which included trauma patient simulations, content expert lectures, group discussion of video demonstrations, and skill development workstations. Baseline and acquired knowledge were assessed through the use of confidence surveys, cognitive questionnaires, and a validated evaluation tool of teamwork and leadership skills for traumaResults: Fifteen interns entered the boot camp with an overall confidence score of 3.2 (1-5 scale) in the management of trauma cases. At the culmination of the study, there was a significant increase in the overall confidence level of interns in role delegation, leadership, Crisis Resource Management (CRM) principles, and in the performance of primary and secondary surveys. No significant changes were seen in determining and effectively using the Glasgow Coma Scale, Orthopedic splinting/reduction skills, and effective use of closed-loop communication.Conclusion: An intensive one-day trauma boot camp demonstrated significant improvement in self-reported confidence of CRM concepts, role delegation, leadership, and performance of primary and secondary surveys. Despite the intensive curriculum, there was no significant improvement in overall teamwork and leadership performance during simulated cases. Our boot camp curriculum offers educators a unique framework to which they can apply to their own training program as a foundation for effective leadership and teamwork training for interns.

Self-Confidence on Acquired Surgical Skills to Deal With Severe Trauma Patients in Recently Graduated Surgeons

“…These programs have demonstrated to shorten the learning curve and the transfer of the acquired skills to the operating room 6,8,38 . In trauma surgery, some training courses exists such as the ATLS, widely used in our country, but focuses on general skills rather than the acquisition of surgical competences 24,28 . Other courses, like the ATOM, ASSET (ACS), or DQT (from the Panamerican Society of Trauma), enable the acquisition of surgical skills, but they are less available and are often associated with animal ethical concerns and high costs 1,19 .…”

Pediatric Trauma Boot Camp: A Simulation Curriculum and Pilot Study

“…There are previously published studies with similar curricula. Ortiz Figueroa et al developed a one-day boot camp for emergency medicine interns focused on trauma management [ 9 ]. Their training included hands-on skills, didactics, and simulation scenarios and it similarly demonstrated an increase in confidence in CRM principles of role delegation, leadership, and performance of the primary and secondary survey.…”

“…In the ATLS course, there is little to no guidance on effective leadership, teamwork, or effective communication as a trauma team leader [ 9 ]. Additionally, there is very limited discussion about pediatric trauma [ 10 ].…”

Communication and leadership in emergency situations: Systematic literature review and recommendations for practice

“…[4,5,11,13,16,18,22,[24][25][26]29] Simulation-based training is an important pedagogical tool to consolidate knowledge, [30,31] develop acute care skills, maintain proficiency, [30,[32][33][34] and produce leaders. [35][36][37][38][39] Communication and leadership are two closely related concepts, [13] to the extent that effective leadership requires effective communication [4,10,11,19,24,26] at different levels: to collect and process data; [14] to make quick [13,22] and correct decisions; [16,19,22] to achieve a more effective teamwork; [13,17,23,25] to motivate the team; [14] to improve the overall quality of the response; [4,14,15,20,24,29] and to improve patient safety. [4, 13-15, 18, 19, 22, 24] Lead...…”