Jane J Keating, Jonathan D Gates, Matthew Tichauer, Thomas Nowicki, Monika Nelson, Alfred Croteau, Greg Frani, Matthew Lissauer, Lenworth M Jacobs
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引用次数: 0
Abstract
Background: Increasing global conflicts continue to heighten the need for increased focus on preparedness for military physicians and surgeons. Simulation has recently been adopted by civilian surgical trainees to offset the problem of increased work hour restrictions and shift the current focus toward minimally invasive techniques. We hypothesized that just-in-time trauma training, incorporating both focused clinical and simulated experience at our civilian Level I Trauma Center, would increase the competence and confidence of international military physicians in trauma care.
Methods: We performed a feasibility study of five Ukrainian physicians (four surgeons and one anesthesiologist) undergoing an intensive 2-week trauma course taught by 25 American clinicians. The training consisted of several previously validated courses including Advanced Trauma Life Support (ATLS®), Advanced Surgical Skills for Exposure in Trauma (ASSE'J®), Advanced Trauma Operative Management (ATO ), and Basic Endovascular Skills for Trauma (BES'J®), among several additional simulated and clinical experiences. Pre- and post-course surveys were analyzed using paired t-tests to assess improvement in trauma care.
Results: All five physicians had significant improvement in confidence following the completion of the course, including the management of injuries to the neck, chest, abdomen, and extremities. Additionally, each clinician significantly improved in their confidence to perform common ATLS procedures and resuscitative endovascular balloon occlusion of the aorta skills. Overall, the mean confidence over all survey responses improved significantly following the completion of the course, 2.28 (precourse confid ence range 1.25-3.35) to 3.66 (post-course confidence range 2.95-4.22), p-value = 0.002. All five Ukrainian physicians successfully passed the corresponding post-tests and were certified as having completed ATLS, ATOM, ASSET, and BEST Conclusions: A military and civilian partnership in trauma preparedness is feasible to improve surgeon confidence in trauma care.
期刊介绍:
With the publication of the American Journal of Disaster Medicine, for the first time, comes real guidance in this new medical specialty from the country"s foremost experts in areas most physicians and medical professionals have never seen…a deadly cocktail of catastrophic events like blast wounds and post explosion injuries, biological weapons contamination and mass physical and psychological trauma that comes in the wake of natural disasters and disease outbreak. The journal has one goal: to provide physicians and medical professionals the essential informational tools they need as they seek to combine emergency medical and trauma skills with crisis management and new forms of triage.