Team play in surgical education: a simulation-based study.
BACKGROUND
Simulation-based training provides a low-stress learning environment where real-life emergencies can be practiced. Simulation can improve surgical education and patient care in crisis situations through a team approach emphasizing interpersonal and communication skills.


OBJECTIVE
This study assessed the effects of simulation-based training in the context of trauma resuscitation in teams of trainees.


METHODS
In a New York State-certified level I trauma center, trauma alerts were assessed by a standardized video review process. Simulation training was provided in various trauma situations followed by a debriefing period. The outcomes measured included the number of healthcare workers involved in the resuscitation, the percentage of healthcare workers in role position, time to intubation, time to intubation from paralysis, time to obtain first imaging study, time to leave trauma bay for computed tomography scan or the operating room, presence of team leader, and presence of spinal stabilization. Thirty cases were video analyzed presimulation and postsimulation training. The two data sets were compared via a 1-sided t test for significance (p < 0.05). Nominal data were analyzed using the Fischer exact test.


RESULTS
The data were compared presimulation and postsimulation. The number of healthcare workers involved in the resuscitation decreased from 8.5 to 5.7 postsimulation (p < 0.001). The percentage of people in role positions increased from 57.8% to 83.6% (p = 0.46). The time to intubation from paralysis decreased from 3.9 to 2.8 minutes (p < 0.05). The presence of a definitive team leader increased from 64% to 90% (p < 0.05). The rate of spine stabilization increased from 82% to 100% (p < 0.08). After simulation, training adherence to the advanced trauma life support algorithm improved from 56% to 83%.


CONCLUSIONS
High-stress situations simulated in a low-stress environment can improve team interaction and educational competencies. Providing simulation training as a tool for surgical education may enhance patient care.
Department of Surgery, New York University School of Medicine, New York, New York 10016, USA.
Mollie
M
Marr
Keith
K
Hemmert
Andrew H
AH
Nguyen
Ronnie
R
Combs
Alagappan
A
Annamalai
George
G
Miller
H Leon
HL
Pachter
James
J
Turner
Kenneth
K
Rifkind
Steven M
SM
Cohen
D004503:Education, Medical, Graduate / Q000379:methods*; D004638:Emergency Treatment; D013502:General Surgery / Q000193:education*; D006126:Group Processes; D016544:Patient Simulation; D018794:Problem-Based Learning; D011446:Prospective Studies; D012151:Resuscitation; D014947:Wounds and Injuries / Q000628:therapy