Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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VOLUME 7 , ISSUE 2 ( May-August, 2018 ) > List of Articles


Guiding Observers in Trauma Simulation Education: The Effect of Directed Simulation Observation on Achieving Educational Objectives

Ali Tabatabai, Alex Skog, Pamela Griffin, Anshum Sood, F.Jacob Seagull

Keywords : Checklist, High fidelity simulation training, Patient simulation, Simulation, Simulation training, Trauma

Citation Information : Tabatabai A, Skog A, Griffin P, Sood A, Seagull F. Guiding Observers in Trauma Simulation Education: The Effect of Directed Simulation Observation on Achieving Educational Objectives. Panam J Trauma Crit Care Emerg Surg 2018; 7 (2):108-113.

DOI: 10.5005/jp-journals-10030-1213

License: CC BY-NC 4.0

Published Online: 01-04-2007

Copyright Statement:  Copyright © 2018; The Author(s).


Introduction: It is known that medical education can be augmented by simulation, that active participant, and observers demonstrate educational benefit. What is not well researched are strategies for maximizing observer benefit. Human patient simulation is of growing importance in the era of restricted duty hours, but remains a limited resource, restricting the number of learners that can be trained at one time. We hypothesized that a strategy could be employed to increase capacity through structured engagement of observers. The purpose of this study is to assess the effects of structured observation tools on observers’ confidence in content knowledge, task, and procedural skills, and team-based learning. Materials and Methods: A scenario-based simulation course was created and implemented for third-year medical students during their trauma clerkship. Students participated in simulations and observed classmates via a live video stream. One treatment group of observers used a checklist listing critical actions to guide their observation while the control group had no observational aid. Confidence in ability was measured via pre and post-course self-assessments to identify disparities between the groups. The difference in the reported confidence prior to and following the course was analyzed, primarily using t-tests. Results: Overall, students had a significant increase in self-reported competence following the simulation course (p-value < 0.001). Students using the checklist had a greater increase in confidence in competencies involving medical content knowledge and procedural skills (p < 0.05), whereas their counterparts who did not have an observation tool had greater confidence increases in team-based competencies (p < 0.05). Specifically, learners’ confidence in their ability to “communicate clearly with team members” increased more in the group without a checklist (p < 0.05). Conclusion: These findings suggest structured tools directed to the observer impact learning. Checklist observation tools enhanced content knowledge and procedural skill educational objectives, while unaided observation was superior for communication and interpersonal team-based competencies.

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  1. Holcomb JB, Dumire RD, Crommett JW, Stamateris CE, Fagert MA, Cleveland JA, Dorlac GR, et al. Evaluation of Trauma Team Performance Using an Advanced Human Patient Simulator for Resuscitation Training. J Trauma. 2002 Jun;52(6):1078-1086.
  2. Knudson MM, Khaw L, Bullard MK, Dicker R, Cohen MJ, Staudenmayer K, et al. Trauma training in simulation: translating skills from SIM time to real time. J Trauma. 2008 Feb;64(2):255-264.
  3. Ostergaard D, Dieckmann P, Lippert A. Simulation and CRM. Best Pract Res Clin Anaesthesiol. 2011 Jun;25(2):239-249.
  4. Bond WF, Spillane L. The use of simulation for emergency medicine resident assessment. Acad Emerg Med. 2002 Nov;9(11):1295-1299.
  5. Hammond J, Bermann M, Chen B, Kushins L. Incorporation of a computerized human patient simulator in critical care training: a preliminary report. J Trauma. 2002 Dec;53(6):1064-1067.
  6. Mathai SK, Miloslavsky EM, Contreras-Valdes FM, Milosh- Zinkus T, Hayden EM, Gordon JA, et al. How we implemented a resident-led medical simulation curriculum in a large internal medicine residency program. Med Teach. 2014 Apr;36(4):279-283.
  7. American Council on Graduate Medical Education. General competencies: minimum program requirements language. ACGME, Chicago, 2013.
  8. Accreditation Council for Graduate Medical Education (ACGME). ACGME Duty Hours. Available at: http://www. CPRs2013.pdf. Accessed February 12, 2014.
  9. Wagner MJ, Wolf S, Promes S, McGee D, Hobgood C, Doty C, et al. Duty hours in emergency medicine: balancing patient safety, resident wellness, and the resident training experience: a consensus response to the 2008 institute of medicine resident duty hours recommendations. Acad Emerg Med. 2010 Sep;17(9):1004–1011.
  10. O'Toole JK, Solan LG, Yau C, Weiser J, Sucharew H, Simmons JM. Pediatric hospitalist perceptions of the impact of duty hour changes on education and patient care. Hosp Pediatr. 2013 Apr;3(2):162–166.
  11. Marshall MB. Simulation for technical skills. J Thorac Cardiovasc Surg. 2012 Sep;144(3):S43–S47.
  12. Watson DR, Flesher TD, Ruiz O, Chung JS. Impact of the 80-hour workweek on surgical case exposure within a general surgery residency program. J Surg Educ. 2010 Sep- Oct;67(5):283-289.
  13. Ellison S, Sullivan C, McCullough R. No longer waiting for an accident to happen: Simulation in emergency medicine. Mo Med. 2013 Mar–Apr;110(2):133–138.
  14. Young I, Montgomery K, Kearns P, Hayward S, Mellanby E. The benefits of a peer-assisted mock OSCE. Clin Teach. 2014 Jun;11(3):214–218.
  15. Bloch SA, Bloch AJ. Simulation training based on observation with minimal participation improves paediatric emergency medicine knowledge, skills, and confidence. Emerg Med J. 2015 Mar;32(3):195-202.
  16. Berenholtz SM, Pronovost PJ, Lipsett PA, Hobson D, Earsing K, Farley JE, et al. Eliminating catheter-related bloodstream infections in the intensive care unit. Crit Care Med. 2004 Oct;32(10):2014-2020.
  17. Erdek MA, Pronovost PJ. Improving assessment and treatment of pain in the critically ill. Int J Qual Health Care. 2004 Feb;16(1):59-64.
  18. DuBose JJ, Inaba K, Shiflett A, Trankiem C, Teixeira PG, Salim A, et al. Measurable outcomes of quality improvement in the trauma intensive care unit: the impact of a daily quality rounding checklist. J Trauma. 2008 Jan;64(1):22-7; discussion 27-29.
  19. Steinemann S, Berg B, Skinner A, Di Tulio A, Anzelon K, Terada K, et al. In situ, multidisciplinary, simulation-based teamwork training improves early trauma care. J Surg Educ. 2011 Nov-Dec;68(6):472-477.
  20. Skog A, Peyre SE, Pozner CN, Thorndike M, Hicks G, Dellaripa PF. Assessing physician leadership styles: application of the situational leadership model to transitions in patient acuity. Teach Learn Med. 2012 Jul;24(3):225-230.
  21. Peckler B, Prewett MS, Campbell T, Brannick M. Teamwork in the trauma room evaluation of a multimodal team training program. J Emerg Trauma Shock. 2012 Jan;5(1):23-27.
  22. Miller D, Crandall C, Washington C 3rd, McLaughlin S. Improving teamwork and communication in trauma care through in situ simulations. Acad Emerg Med. 2012 May;19(5):608-612.
  23. Morgan PJ, Cleave-Hogg D. Comparison between medical students’ experience, confidence and competence. Med Educ. 2002 Jun;36(6):534–539.
  24. Dayal AK, Fisher N, Magrane D, Goffman D, Bernstein PS, Katz NT. Simulation training improves medical students’ learning experiences when performing real vaginal deliveries. Simul Healthc. 2009;4(3):155–159.
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