title: Hyper-Realistic, Team-Centered Fleet Surgical Team Training Provides Sustained Improvements in Performance.
abstract: OBJECTIVE
  The high-stress, fast-paced environment of combat casualty care relies on effective teamwork and communication which translates into quality patient care. A training course was developed for U.S. Navy Fleet Surgical Teams to address these aspects of patient care by emphasizing efficiency and appropriate patient care. An effective training course provides knowledge and skills to pass the course evaluation and sustain the knowledge and skills acquired over time.
  
  
  METHODS
  The course included classroom didactic hours, and hands-on simulation sessions. A pretest was administered before the course, a posttest upon completion, and a sustainment test 5 months following course completion. The evaluation process measured changes in patient time to disposition and critical errors made during patient care.
  
  
  METHODS
  Naval Base San Diego, with resuscitation and surgical simulations carried out within the shipboard medical spaces.
  
  
  METHODS
  United States Navy medical personnel including physicians of various specialties, corpsmen, nurses, and nurse anesthetists deploying aboard ships.
  
  
  RESULTS
  Time to disposition improved significantly, 11 ± 3 minutes, from pretest to posttest, and critical errors improved by 4 ± 1 errors per encounter. From posttest to sustainment test, time to disposition increased by 3 ± 1, and critical errors decreased by 1 ± 1.
  
  
  CONCLUSIONS
  This course showed value in improving teamwork and communication skills of participants, immediately upon completion of the course, and after 5 months had passed. Therefore, with ongoing sustainment activities within 6 months, this course can substantially improve trauma care provided by shipboard deployed Navy medical personnel to wounded service members.
authors.affiliation: United States Navy.
authors.forename: Tuan N
authors.initials: TN
authors.lastname: Hoang
authors.affiliation: United States Navy.
authors.forename: Jeff
authors.initials: J
authors.lastname: Kang
authors.affiliation: United States Navy.
authors.forename: Kris
authors.initials: K
authors.lastname: Siriratsivawong
authors.affiliation: Rocky Vista University, Parker, Colorado.
authors.forename: Anthony
authors.initials: A
authors.lastname: LaPorta
authors.affiliation: Rocky Vista University, Parker, Colorado.
authors.forename: Amber
authors.initials: A
authors.lastname: Heck
authors.affiliation: United States Navy.
authors.forename: Jessica
authors.initials: J
authors.lastname: Ferraro
authors.affiliation: Rocky Vista University, Parker, Colorado.
authors.forename: Douglas
authors.initials: D
authors.lastname: Robinson
authors.affiliation: Rocky Vista University, Parker, Colorado. Electronic address: jonathan.walsh@rvu.edu.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Walsh
mesh_terms: D002983:Clinical Competence; D003142:Communication; D003479:Curriculum; D004521:Educational Measurement; D004526:Efficiency; D013502:General Surgery / Q000193:education*; D006801:Humans; D008887:Military Medicine / Q000193:education*; D017145:Models, Educational; D010348:Patient Care Team / Q000458:organization & administration*; D011446:Prospective Studies; D012767:Ships; D014194:Traumatology / Q000193:education*; D014481:United States
keywords: Fleet Surgical Team Shipboard Surgical Trauma Training Course; Interpersonal and Communication Skills; Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; combat casualty care; human-worn partial-task surgical simulator; improving teamwork and efficiency in trauma surgery; sustainment training