title: Disaster response team FAST skills training with a portable ultrasound simulator compared to traditional training: pilot study.
abstract: BACKGROUND
  Pre-hospital focused assessment with sonography in trauma (FAST) has been effectively used to improve patient care in multiple mass casualty events throughout the world. Although requisite FAST knowledge may now be learned remotely by disaster response team members, traditional live instructor and model hands-on FAST skills training remains logistically challenging. The objective of this pilot study was to compare the effectiveness of a novel portable ultrasound (US) simulator with traditional FAST skills training for a deployed mixed provider disaster response team.
  
  
  METHODS
  We randomized participants into one of three training groups stratified by provider role: Group A. Traditional Skills Training, Group B. US Simulator Skills Training, and Group C. Traditional Skills Training Plus US Simulator Skills Training. After skills training, we measured participants' FAST image acquisition and interpretation skills using a standardized direct observation tool (SDOT) with healthy models and review of FAST patient images. Pre- and post-course US and FAST knowledge were also assessed using a previously validated multiple-choice evaluation. We used the ANOVA procedure to determine the statistical significance of differences between the means of each group's skills scores. Paired sample t-tests were used to determine the statistical significance of pre- and post-course mean knowledge scores within groups.
  
  
  RESULTS
  We enrolled 36 participants, 12 randomized to each training group. Randomization resulted in similar distribution of participants between training groups with respect to provider role, age, sex, and prior US training. For the FAST SDOT image acquisition and interpretation mean skills scores, there was no statistically significant difference between training groups. For US and FAST mean knowledge scores, there was a statistically significant improvement between pre- and post-course scores within each group, but again there was not a statistically significant difference between training groups.
  
  
  CONCLUSIONS
  This pilot study of a deployed mixed-provider disaster response team suggests that a novel portable US simulator may provide equivalent skills training in comparison to traditional live instructor and model training. Further studies with a larger sample size and other measures of short- and long-term clinical performance are warranted.
authors.affiliation: John H. Stroger, Jr. Hospital of Cook County, Department of Emergency Medicine, Chicago, Illinois.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Paddock
authors.affiliation: John H. Stroger, Jr. Hospital of Cook County, Department of Emergency Medicine, Chicago, Illinois.
authors.forename: John
authors.initials: J
authors.lastname: Bailitz
authors.affiliation: John H. Stroger, Jr. Hospital of Cook County, Department of Emergency Medicine, Chicago, Illinois.
authors.forename: Russ
authors.initials: R
authors.lastname: Horowitz
authors.affiliation: John H. Stroger, Jr. Hospital of Cook County, Department of Emergency Medicine, Chicago, Illinois.
authors.forename: Basem
authors.initials: B
authors.lastname: Khishfe
authors.affiliation: John H. Stroger, Jr. Hospital of Cook County, Department of Emergency Medicine, Chicago, Illinois.
authors.forename: Karen
authors.initials: K
authors.lastname: Cosby
authors.affiliation: John H. Stroger, Jr. Hospital of Cook County, Department of Emergency Medicine, Chicago, Illinois.
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Sergel
mesh_terms: D000328:Adult; D002983:Clinical Competence; D060731:Emergency Responders / Q000193:education*; D005260:Female; D057209:Hospital Rapid Response Team; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D000066908:Simulation Training; D016037:Single-Blind Method; D014463:Ultrasonography
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