title: A comparison of live tissue training and high-fidelity patient simulator: A pilot study in battlefield trauma training.
abstract: BACKGROUND
  Trauma procedural and management skills are often learned on live tissue. However, there is increasing pressure to use simulators because their fidelity improves and as ethical concerns increase. We randomized military medical technicians (medics) to training on either simulators or live tissue to learn combat casualty care skills to determine if the choice of modality was associated with differences in skill uptake.
  
  
  METHODS
  Twenty medics were randomized to trauma training using either simulators or live tissue. Medics were trained to perform five combat casualty care tasks (surgical airway, needle decompression, tourniquet application, wound packing, and intraosseous line insertion). We measured skill uptake using a structured assessment tool. The medics also completed exit questionnaires and interviews to determine which modality they preferred.
  
  
  RESULTS
  We found no difference between groups trained with live tissue versus simulators in how they completed each combat casualty care skill. However, we did find that the modality of assessment affected the assessment score. Finally, we found that medics preferred trauma training on live tissue because of the fidelity of tissue handling in live tissue models. However, they also felt that training on simulators also provided additional training value.
  
  
  CONCLUSIONS
  We found no difference in performance between medics trained on simulators versus live tissue models. Even so, medics preferred live tissue training over simulation. However, more studies are required, and future studies need to address the measurement bias of measuring outcomes in the same model on which the study participants are trained.
  
  
  METHODS
  Therapeutic/care management study, level II.
authors.affiliation: From the Royal Canadian Medical Service (E.C.S., D.P., H.C.T); Defence Research Development Canada (C.T., O.V., K.B., W.S.-K., M.G., A.-R.B., J.J., H.P.); and Sunnybrook Health Sciences Center (H.C.T.), Toronto, Canada.
authors.forename: Erin C
authors.initials: EC
authors.lastname: Savage
authors.forename: Catherine
authors.initials: C
authors.lastname: Tenn
authors.forename: Oshin
authors.initials: O
authors.lastname: Vartanian
authors.forename: Kristen
authors.initials: K
authors.lastname: Blackler
authors.forename: Wendy
authors.initials: W
authors.lastname: Sullivan-Kwantes
authors.forename: Michelle
authors.initials: M
authors.lastname: Garrett
authors.forename: Ann-Renee
authors.initials: AR
authors.lastname: Blais
authors.forename: Jerzy
authors.initials: J
authors.lastname: Jarmasz
authors.forename: Henry
authors.initials: H
authors.lastname: Peng
authors.forename: Dylan
authors.initials: D
authors.lastname: Pannell
authors.forename: Homer C
authors.initials: HC
authors.lastname: Tien
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada; D004521:Educational Measurement; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008348:Manikins; D008875:Middle Aged; D008887:Military Medicine / Q000193:education*; D010865:Pilot Projects; D011361:Professional Competence; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014194:Traumatology / Q000193:education*