Multidisciplinary pediatric trauma team training using high-fidelity trauma simulation

doi:10.1016/j.jpedsurg.2008.02.033

Journal of Pediatric Surgery

Volume 43, Issue 6, June 2008, Pages 1065-1071

https://doi.org/10.1016/j.jpedsurg.2008.02.033 Get rights and content

Abstract

Background

Trauma resuscitations require a high level of team performance. This study evaluated the impact of a comprehensive effort to improve trauma care through multidisciplinary education and the use of simulation training to reinforce training and evaluate performance.

Methods

For a 1-year period, expanded trauma education including monthly trauma simulation sessions using high-fidelity simulators was implemented. All members of the multidisciplinary trauma resuscitation team participated in education, including simulations. Each simulation session included 2 trauma scenarios that were videotaped for debriefing as well as subsequent analysis of team performance. Scored simulations were divided into early (initial 4 months) and late (final 4 months) for comparison.

Results

For the first year of the program, 160 members of our multidisciplinary team participated in the simulation. In the early group, the mean percentage of appropriately completed tasks was 65%, whereas in the late group, this increased to 75% (P < .05). Improvements were also observed in initial assessment, airway management, management of pelvic fractures, and cervical spine care.

Conclusions

Training of a multidisciplinary team in the care of pediatric trauma patients can be enhanced and evaluated through the use of high-fidelity simulation. Improvements in team performance using innovative technology can translate into more efficient care with fewer errors.

Section snippets

Methods

For a 1-year study period, an emphasis on team function and communication was incorporated into all trauma education activities including resident orientation, morbidity and mortality conference, monthly videotape review, and quarterly pediatric trauma grand rounds. In addition, a core group of nurses received increased training and education in pediatric trauma. This trauma core nursing team participated in a web-based core curriculum and monthly trauma lectures. To complement all of these

Results

For the 12-month period, a total of 23 two-hour multidisciplinary trauma simulation sessions were conducted in addition to didactic trauma education. These sessions involved 160 individuals from multiple domains of the trauma care team (Table 1). The average team consisted of 6 members. Teams were led by a surgical faculty, emergency medicine faculty, or senior surgical resident. The distribution of team leaders was consistent throughout the study period. The trauma core nurses were the only

Discussion

As a consequence of a hospital-wide commitment to quality and improving safety, we have expanded our trauma education initiatives including the addition of multidisciplinary trauma simulation training and evaluation. Previous reports of simulation training have demonstrated improvements of individuals, teams of surgeons only, and previously established military teams [18], [19], [20], [21], [23]. In most trauma centers however, resuscitations are managed by a complex team made up of trauma

Acknowledgment

The authors would like to thank the simulator staff at Cincinnati Children's Hospital (Cincinatti, Ohio), in particular Mike Moyer, Brian Pio, and Tom Lemaster for their expertise and dedication to trauma simulation. We would also like to thank all of the participants throughout the hospital who continue to improve for the benefit of injured children.

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: Presented at the 59th Annual Meeting of the Section on Surgery, American Academy of Pediatrics, San Francisco, CA, October 25-27, 2007.

View full text

Multidisciplinary pediatric trauma team training using high-fidelity trauma simulation

Abstract

Background

Methods

Results

Conclusions

Section snippets

Methods

Results

Discussion

Acknowledgment

J Am Coll Surg

Resuscitation

J Pediatr Surg

The human factor: the critical importance of effective teamwork and communication in providing safe care

Qual Saf Health Care

The challenge of changing roles and improving surgical care now: crew resource management approach

Am Surg

The design and delivery of crew resource management training: exploiting available resources

Hum Factors

Error reduction and performance improvement in the emergency department through formal teamwork training: evaluation results of the MedTeams project

Health Serv Res

The complexity of team training: what we have learned from aviation and its application to medicine

Qual Safe Health Care

Aviation model cognitive risk factors applied to medical malpractice cases

J Am Board Fam Med

Team communication in the operating room

Acta Anaesthesiol Scand

The culture of a trauma team in relation to human factors

J Clin Nurs

Promoting health care safety through training high reliability teams

Qual Saf Health Care

A review of flight simulator transfer of training studies

Hum Factors