Interprofessional Trauma Team Training: Leveraging Each Specialties’ Expertise to Teach Procedural-Based Skills

Elsevier

Available online 23 October 2022

Journal of Surgical EducationOBJECTIVE

The goal of this study was to utilize interprofessional trauma team training to teach procedural-based skills, teamwork, and assess the impact on the procedural comfort and interprofessional collaboration.

DESIGN

Interdisciplinary skills sessions were created to focus on chest tube placement and advanced ultrasound techniques. Chest tube sessions were taught by senior general surgery (GS) residents and faculty. Ultrasound sessions were taught by emergency medicine (EM) fellows and faculty. Mock trauma simulations for EM and GS residents and EM nurses, were developed to also focus on improving interprofessional trauma-bay collaboration. Sessions were held throughout the year for 2 consecutive academic years. After completing skills sessions and trauma scenarios, participants were surveyed on skill comfort, session utility, and willingness to collaborate with the other specialty. Likert scale responses were analyzed by specialty cohort and in aggregate. Free-text feedback responses were analyzed for common themes.

SETTING

Large, tertiary, urban academic medical center

PARTICIPANTS

Forty seven EM residents and 32 GS residents completed instructional chest tube and ultrasound simulations, respectively. Twenty two EM residents, 24 GS residents, and 29 EM nurses participated in interprofessional trauma simulations.

RESULTS

For chest tube placement: 71% of EM residents reported feeling uncomfortable with the procedure prior to the session, with 100% reporting improved confidence afterwards. Seventy percent stated the model was realistic. One hundred percent thought it improved their procedural skills. All participants thought it was worthwhile, should be offered again in future years, and planned to incorporate what they learned in their future practice. For the ultrasound sessions: 61% of GS residents felt uncomfortable with the Focused Assessment with Sonography in Trauma prior to the simulation. Ninety four percent reported the improved skill and confidence, and felt the model was realistic. All participants felt sessions were worthwhile, should be offered again, and planned to incorporate what they learned in their future practice. For trauma simulations: 97% of participants felt scenarios were realistic and clinically relevant and planned to incorporate lessons learned in their future clinical practice. All participants thought participation was worthwhile. Ninety seven percent thought it improved their confidence with trauma clinical management and 56% reported it improved their skills. Many participants reported they appreciated learning from the other specialty's perspective, with greater than 95% of all participants reporting improved comfort and willingness to collaborate across disciplines when caring for future trauma patients. All participants requested the simulation sessions continue in future academic years.

CONCLUSION

Interprofessional trauma simulation sessions can harness the unique skill sets of different disciplines to teach procedural-based skills and improve interprofessional collaboration within the trauma bay.

Section snippetsINTRODUCTION

Caring for patients in the emergency department (ED) requires a balance between ever-growing pressure to reduce overcrowding and wait times and the simultaneous need to negotiate consultations from subspecialists.1 Surgical consultation and the joint management of trauma patients is a common scenario in the ED. Trauma care is provided by a range of providers and healthcare facilities, including teaching hospitals. When learners are involved in the complex care of trauma patients, it often

Study Setting and Participants

This study took place at the Massachusetts General Hospital (MGH), a Level 1 Adult Trauma Center and Level 1 Pediatric Trauma Center verified by the American College of Surgeons. At this institution, the learners on the adult trauma team include a dedicated trauma surgery consult team (PGY-2 and PGY-3) and a surgical trauma senior (PGY-4) who interact daily with the EM resident team (PGY- 2-4). These surgical learners also interact daily with EM faculty, and ED nursing staff. The adult trauma

Needs Assessment

A total of 14 (48.2%) EM residents, 17 (70.8%) GS residents, and 47 (42.7%) EM nurses eligible to participate completed the survey following the 2018 to 2019 academic year. When evaluating their relationship with EM residents, GS residents felt it was important to communicate with their EM colleagues, felt EM residents are understanding about each discipline's respective responsibilities, and thought EM residents would discuss new practices with them to help with workflow. However, GS residents

DISCUSSION

In response to negative relationship themes discovered between EM residents, GS residents, and ED nurse during our needs assessment, we established a novel collaborative skills curriculum and interprofessional trauma training program. Overall, the curriculum appeared to be effective at not merely improving resident comfort and technical skills, but also cross-disciplinary collaboration between trauma care departments. Prior to the curriculum, each of the 3 groups reported that interdisciplinary

CONCLUSION

Interprofessional trauma simulation sessions can harness the unique skill sets of different disciplines to teach procedural-based skills and improve interprofessional collaboration within the trauma bay. The simulation sessions are clinically relevant, realistic, and can improve trainees’ comfort with skills necessary when caring for trauma bay patients. Overall, the sessions are well-received and foster a willingness to learn from each other's department outside of the trauma bay.

Supplementaly

Supplemental File 1: Interprofessional Collaboration (IPC) Survey Instruments for General Surgery Residents, Emergency Medicine Residents, and Emergency Medicine Staff

Supplemental File 2: Trauma Scenario 1 for Trauma Team Training Simulation: Motor Vehicle Collision & Pelvic Fracture

Supplemental File 3: Trauma Scenario 2 for Trauma Team Training Simulation: Elderly Head Injury

Supplemental File 4: Trauma Scenario 3 for Trauma Team Training Simulation: Motor Vehicle Collision & Burn

Supplemental

Declaration of competing interest

None

Funding

This study was supported by a Mass General Brigham (MGB) Executive Committee on Teaching and Education (ECOTE) grant. The authors declare no financial disclosures or conflicts of interest.

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© 2022 Published by Elsevier Inc. on behalf of Association of Program Directors in Surgery.

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