Connie C Schmitz1, Jeffrey G Chipman1, Ken Yoshida1, Rachel Isaksson Vogel2, Francois Sainfort3, Gregory Beilman1, Joseph Clinton4, Jimmy Cooper5, Troy Reihsen6, Robert M Sweet6. 1. Department of Surgery, University of Minnesota Medical School, 516 Delaware Street SE Room, Minneapolis, MN 55455. 2. University of Minnesota Masonic Cancer Center, 717 Delaware Street SE Room 130, Minneapolis, MN 55455. 3. University of Minnesota School of Public Health, Health Policy & Management, 420 Delaware Street SE MMC 729, Minneapolis, MN 55455. 4. Department of Emergency Medicine, University of Minnesota Medical School, 717 Delaware Street SE, Minneapolis, MN 55455. 5. Center for Predeployment Medicine, Army Medical Department Center and School, 2403 N. New Braunfels, JBSA Fort Sam Houston, TX 78234. 6. Simulation PeriOperative Resources for Training and Learning/CREST, University of Minnesota Medical School, 420 Delaware Street SE MMC 394, Minneapolis, MN 55455.
Abstract
OBJECTIVES: Reducing preventable deaths because of uncontrolled hemorrhage, tension pneumothorax, and airway loss is a priority. As part of a research initiative comparing different training models, this study evaluated the reliability and validity of a test that assesses combat medic performance during a polytrauma scenario using live animal models. METHODS: Nine procedural checklists and seven global rating scales were piloted with four cohorts of soldiers (n = 94) at two U.S. training sites. Cohorts represented "novice" to "proficient" trainees. Procedure scores and a mean global score were calculated per subject. The intraclass correlation was calculated per procedure, with 0.70 as the threshold for acceptability. An overall difference among cohorts was hypothesized: Cohort 4 (proficient) > Cohort 3 (competent) > Cohort 2 (beginners) > Cohort 1 (novice) trainees. Data were analyzed using Kruskal-Wallis and analysis of variance. RESULTS: At Site A, intraclass correlation coefficients ranged from 74% to 93% for 6 of 9 procedures. Cohorts differed significantly on hemorrhage control, needle decompression, cricothyrotomy, amputation management, chest tube insertion, and mean global scores. Cohort 4 outperformed the others, and Cohorts 2 and 3 outperformed Cohort 1. CONCLUSION: The test differentiates novices from beginners, competent, and proficient trainees on difficult procedures and overall performance. Reprint &
OBJECTIVES: Reducing preventable deaths because of uncontrolled hemorrhage, tension pneumothorax, and airway loss is a priority. As part of a research initiative comparing different training models, this study evaluated the reliability and validity of a test that assesses combat medic performance during a polytrauma scenario using live animal models. METHODS: Nine procedural checklists and seven global rating scales were piloted with four cohorts of soldiers (n = 94) at two U.S. training sites. Cohorts represented "novice" to "proficient" trainees. Procedure scores and a mean global score were calculated per subject. The intraclass correlation was calculated per procedure, with 0.70 as the threshold for acceptability. An overall difference among cohorts was hypothesized: Cohort 4 (proficient) > Cohort 3 (competent) > Cohort 2 (beginners) > Cohort 1 (novice) trainees. Data were analyzed using Kruskal-Wallis and analysis of variance. RESULTS: At Site A, intraclass correlation coefficients ranged from 74% to 93% for 6 of 9 procedures. Cohorts differed significantly on hemorrhage control, needle decompression, cricothyrotomy, amputation management, chest tube insertion, and mean global scores. Cohort 4 outperformed the others, and Cohorts 2 and 3 outperformed Cohort 1. CONCLUSION: The test differentiates novices from beginners, competent, and proficient trainees on difficult procedures and overall performance. Reprint &
Authors: Maria Del Carmen Usero-Pérez; Maria Lourdes Jiménez-Rodríguez; Alexandra González-Aguña; Valentín González-Alonso; Luis Orbañanos-Peiro; Jose María Santamaría-García; Jorge Luís Gómez-González Journal: Rev Lat Am Enfermagem Date: 2020-04-17