title: Reliability and validity of a test designed to assess combat medics' readiness to perform life-saving procedures.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  The test differentiates novices from beginners, competent, and proficient trainees on difficult procedures and overall performance.
authors.affiliation: Department of Surgery, University of Minnesota Medical School, 516 Delaware Street SE Room, Minneapolis, MN 55455.
authors.forename: Connie C
authors.initials: CC
authors.lastname: Schmitz
authors.affiliation: Department of Surgery, University of Minnesota Medical School, 516 Delaware Street SE Room, Minneapolis, MN 55455.
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Chipman
authors.affiliation: Department of Surgery, University of Minnesota Medical School, 516 Delaware Street SE Room, Minneapolis, MN 55455.
authors.forename: Ken
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: University of Minnesota Masonic Cancer Center, 717 Delaware Street SE Room 130, Minneapolis, MN 55455.
authors.forename: Rachel Isaksson
authors.initials: RI
authors.lastname: Vogel
authors.affiliation: University of Minnesota School of Public Health, Health Policy & Management, 420 Delaware Street SE MMC 729, Minneapolis, MN 55455.
authors.forename: Francois
authors.initials: F
authors.lastname: Sainfort
authors.affiliation: Department of Surgery, University of Minnesota Medical School, 516 Delaware Street SE Room, Minneapolis, MN 55455.
authors.forename: Gregory
authors.initials: G
authors.lastname: Beilman
authors.affiliation: Department of Emergency Medicine, University of Minnesota Medical School, 717 Delaware Street SE, Minneapolis, MN 55455.
authors.forename: Joseph
authors.initials: J
authors.lastname: Clinton
authors.affiliation: Center for Predeployment Medicine, Army Medical Department Center and School, 2403 N. New Braunfels, JBSA Fort Sam Houston, TX 78234.
authors.forename: Jimmy
authors.initials: J
authors.lastname: Cooper
authors.affiliation: Simulation PeriOperative Resources for Training and Learning/CREST, University of Minnesota Medical School, 420 Delaware Street SE MMC 394, Minneapolis, MN 55455.
authors.forename: Troy
authors.initials: T
authors.lastname: Reihsen
authors.affiliation: Simulation PeriOperative Resources for Training and Learning/CREST, University of Minnesota Medical School, 420 Delaware Street SE MMC 394, Minneapolis, MN 55455.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Sweet
mesh_terms: D000818:Animals; D002983:Clinical Competence; D004521:Educational Measurement / Q000379:methods; D004634:Emergency Medical Technicians; D004638:Emergency Treatment / Q000592:standards*; D006801:Humans; D008889:Military Personnel; D023421:Models, Animal; D009104:Multiple Trauma / Q000628:therapy*; D015588:Observer Variation; D015203:Reproducibility of Results; D014481:United States