Using Simulation to Address a Training Gap in Battlefield Ocular Trauma: A Lateral Canthotomy and Cantholysis (LCC) Prototype Training System.

Over the past 15 years of conflict, eye injuries have ocurred at a steady rate of 5-10% of combat casualties, attributed to the enemy's use of improvised explosive devices. Many of these injuries result in a compartment syndrome of the orbit, easily decompressed through the use of a simple procedure called a Lateral Canthotomy and Cantholysis (LCC). Current training curricula at the U.S. Army Center for Pre-Hospital Medicine at Fort Sam Houston, Texas incorporates LCC training presented in lectures and taught using cadavers and goats (resources permitting), but lacks a LCC training device for the development of psychomotor skills. Requirements analysis, iterative design and development, and testing were performed for a simulation-based training system that may be used to practice the LCC procedure. Subject matter experts have conducted numerous reviews of the prototype system, where feedback is used to drive subsequent designs. Further work, including formal analysis of training effectiveness, will be performed to validate the training system. This will benefit will benefit military and civilian training programs by training psychomotor skills to enhance competency in the LCC procedure for preserving eyesight. Published by Oxford University Press on behalf of Association of Military Surgeons of the United States 2019.