title: Model for Team Training Using the Advanced Trauma Operative Management Course: Pilot Study Analysis.
abstract: BACKGROUND
  Education and training of surgeons has traditionally focused on the development of individual knowledge, technical skills, and decision making. Team training with the surgeon's operating room staff has not been prioritized in existing educational paradigms, particularly in trauma surgery. We aimed to determine whether a pilot curriculum for surgical technicians and nurses, based on the American College of Surgeons' Advanced Trauma Operative Management (ATOM) course, would improve staff knowledge if conducted in a team-training environment.
  
  
  METHODS
  Between December 2012 and December 2014, 22 surgical technicians and nurses participated in a curriculum complementary to the ATOM course, consisting of 8 individual 8-hour training sessions designed by and conducted at our institution. Didactic and practical sessions included educational content, hands-on instruction, and alternating role play during 5 system-specific injury scenarios in a simulated operating room environment. A pre- and postcourse examination was administered to participants to assess for improvements in team members' didactic knowledge.
  
  
  RESULTS
  Course participants displayed a significant improvement in didactic knowledge after working in a team setting with trauma surgeons during the ATOM course, with a 9-point improvement on the postcourse examination (83%-92%, p = 0.0008). Most participants (90.5%) completing postcourse surveys reported being "highly satisfied" with course content and quality after working in our simulated team-training setting.
  
  
  CONCLUSIONS
  Team training is critical to improving the knowledge base of surgical technicians and nurses in the trauma operative setting. Improved communication, efficiency, appropriate equipment use, and staff awareness are the desired outcomes when shifting the paradigm from individual to surgical team training so that improved patient outcomes, decreased risk, and cost savings can be achieved.
  
  
  OBJECTIVE
  Determine whether a pilot curriculum for surgical technicians and nurses, based on the American College of Surgeons' ATOM course, improves staff knowledge if conducted in a team-training environment.
  
  
  METHODS
  Surgical technicians and nurses participated in a curriculum complementary to the ATOM course. In all, 8 individual 8-hour training sessions were conducted at our institution and contained both didactic and practical content, as well as alternating role play during 5 system-specific injury scenarios. A pre- and postcourse examination was administered to assess for improvements in didactic knowledge.
  
  
  METHODS
  The course was conducted in a simulated team-training setting at the Legacy Institute for Surgical Education and Innovation (Portland, OR), an American College of Surgeons Accredited Educational Institute.
  
  
  METHODS
  In all, 22 surgical technicians and operating room nurses participated in 8 separate ATOM(s) courses and had at least 1 year of surgical scrubbing experience in general surgery with little or no exposure to Level I trauma surgical care. Of these participants, 16 completed the postcourse examination.
  
  
  RESULTS
  Participants displayed a significant improvement in didactic knowledge (83%-92%, p = 0.0008) after the ATOM(s) course. Of the 14 participants who completed postcourse surveys, 90.5% were "highly satisfied" with the course content and quality.
  
  
  CONCLUSIONS
  Team training is critical to improving the knowledge base of surgical technicians and nurses in the trauma operative setting and may contribute to improved patient outcomes, decreased risk, and hospital cost savings.
authors.affiliation: Legacy Institute for Surgical Education and Innovation, Legacy Research Institute, Portland, Oregon; Legacy Research Institute, Portland, Oregon. Electronic address: rsperkin@lhs.org.
authors.forename: R Serene
authors.initials: RS
authors.lastname: Perkins
authors.affiliation: Legacy Institute for Surgical Education and Innovation, Legacy Research Institute, Portland, Oregon.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Lehner
authors.affiliation: Legacy Institute for Surgical Education and Innovation, Legacy Research Institute, Portland, Oregon.
authors.forename: Randy
authors.initials: R
authors.lastname: Armstrong
authors.affiliation: Legacy Research Institute, Portland, Oregon.
authors.forename: Stuart K
authors.initials: SK
authors.lastname: Gardiner
authors.affiliation: Legacy Emanuel Medical Center, Portland, Oregon.
authors.forename: Riyad C
authors.initials: RC
authors.lastname: Karmy-Jones
authors.affiliation: Legacy Emanuel Medical Center, Portland, Oregon.
authors.forename: Seth D
authors.initials: SD
authors.lastname: Izenberg
authors.affiliation: Legacy Emanuel Medical Center, Portland, Oregon.
authors.forename: William B
authors.initials: WB
authors.lastname: Long
authors.affiliation: Legacy Research Institute, Portland, Oregon; Ear and Skull Base Center, Portland, Oregon.
authors.forename: P Ashley
authors.initials: PA
authors.lastname: Wackym
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D006801:Humans; D017145:Models, Educational; D013527:Perioperative Nursing / Q000193:education*; D010865:Pilot Projects; D012189:Retrospective Studies; D014194:Traumatology / Q000193:education*
keywords: ACS-AEI; ATOM; Interpersonal and Communication Skills; Medical Knowledge; Practice-Based Learning and Improvement; Systems-Based Practice; communication; simulation; team training; trauma