MedEdPORTAL (Feb 2014)
A Trauma Resuscitation Team Leader Training Curriculum Based on Eight Human Patient Simulations
Abstract
Abstract Introduction The trauma resuscitation team leader is primarily responsible for conducting the initial assessment and survey, coordinating and directing team and individual activities, and formulating plans for definitive management of acutely-injured patients. Given potential deficiencies in trauma resuscitation leader performance in the domains of advanced trauma life support (ATLS) adherence and leadership behaviors, we developed a trauma resuscitation team leader training curriculum. Methods This curriculum is focused on the trauma resuscitation team leader—typically a junior resident in surgery, emergency medicine, or physician extenders— and therefor only one adult learner at a time. At the simulation center, the team leader is oriented to the simulated trauma bay, the SimMan simulator, and the other members of the team. After this introduction, the team leader has a one-on-one didactic session with the trauma surgeon. In this didactic session, the curriculum is discussed. A sample trauma resuscitation video is viewed and then discussed prior to the start of the modules' eight cases. The cases start when a text page is sent to the team leader. Each simulation takes approximately 5-10 minutes and is video recorded. After the simulation ends, the team leader and the trauma attending view the video, and review all of the outcome measures. Currently, this resource is used only for formative feedback. Results On a 7-point Likert-type scale, the median overall curriculum rating, the video discussion quality, the plan to apply leadership skills, and the plan to apply learned knowledge and behaviors were rated as 7/7. A Wilcoxon sign-rank test showed improved confidence for leading Level 1 trauma resuscitations, improved beliefs in adequate training, and improved attitudes regarding team leader training (p < .05). There was reduced nervousness of being the team leader (p = .048). Qualitative analyses showed that the learners valued the feedback process and scenario realism. Discussion This pilot curriculum was well received by trauma residents and offered insight into the metacognition of trauma team leaders. Similarly, we have shown that confidence for trauma team leaders improves as a direct result of this curriculum. We are currently prospectively evaluating this curriculum, evaluating resident performance in the trauma bay, and looking for differences between individuals that did and did not complete this curriculum at the beginning of the trauma rotation.
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