Advertisement

Lesson Learnt from the Military Surgeons Using Simulation in Trauma Surgery

  • Simon S. Fleming
  • John-Joe Reilly
Chapter

Abstract

The low exposure of many trauma team members to severe trauma underlines the need for alternatives to “learning by doing” when the “doing,” in the early stages, involves a trauma patient. This is unacceptable with today’s patient safety requirements and often unobtainable with modern surgical training. Equally in the dynamic, high-pressured environment of managing trauma patients, the risk of errors occurring and miscommunications is rife. Management of a trauma patient, whether in the emergency department, operating theater, or intensive care unit, relies on the performance of the team as a whole and as such will only work with both effective technical skills but also nontechnical skills such as communication or delegation.

The evidence shows that when a trauma team is trained using simulation, there are significant improvements in the quality of teamwork and a reduction in clinical errors in the trained groups.

Keywords

Trauma Simulation Military Surgery War 

References

  1. 1.
    Morey JC, Simon R, Jay GD, et al. Error reduction and performance improvement in the emergency department through formal teamwork training: evaluation results of the MedTeams project. Health Serv Res. 2002;37:1553–81.PubMedCrossRefGoogle Scholar
  2. 2.
    Smith R. All changed, changed utterly. British medicine will be transformed by the Bristol case. BMJ. 1998;316:1917–8.PubMedCrossRefGoogle Scholar
  3. 3.
    Small S. Thoughts on patient safety education and the role of simulation. Virtual Mentor. 2004;6:3.Google Scholar
  4. 4.
    Gaba D. Anaesthesiology as a model for patient safety in health care. BMJ. 2000;320:785–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Ericsson KA. The acquisition of expert performance: an introduction to some of the issues. In: Ericsson KA, editor. The road to excellence: the acquisition of expert performance in the arts and sciences, sports and games. Mahwah: Lawrence Erlbaum Associates; 1996. p. 1–50.Google Scholar
  6. 6.
    Ericsson KA, Krampe RT, Tesch-Romer C. The role of deliberate practice in the acquisition of expert performance. Psychol Rev. 1993;100:363–406.CrossRefGoogle Scholar
  7. 7.
    Guest CB, Regehr G, Tiberius RG. The lifelong challenge of expertise. Med Educ. 2001;35:78–81.PubMedCrossRefGoogle Scholar
  8. 8.
    Roberts KE, Bell RL, Duffy AJ. Evolution of surgical skills training. World J Gastroenterol. 2006;12:3219–24.PubMedGoogle Scholar
  9. 9.
    Zinn C. 14,000 preventable deaths in Australian hospitals. Br Med J. 1995;310:1487.CrossRefGoogle Scholar
  10. 10.
    Schaefer HG, Helmreich RL. The importance of human factors in the operating room. Anesthesiology. 1994;80(2):479.PubMedCrossRefGoogle Scholar
  11. 11.
    Good ML, Gravenstein JS. Anaesthesia simulators and training devices. Int Anesthesiol Clin. 1989;27:161–8.PubMedCrossRefGoogle Scholar
  12. 12.
  13. 13.
    Fletcher G, Flin R, McGeorge P, Glavin R, Maran N, Patey R. Rating non-technical skills: developing a behavioural marker system for use in anaesthesia. Cogn Technol Work. 2004;6:165–71.CrossRefGoogle Scholar
  14. 14.
    Peters JH, Fried GM, Swanstrom LL, Soper NJ, Sillin LF, Schirmer B, Hoffman K. Development and validation of a comprehensive program of education and assessment of the basic fundamentals of laparoscopic surgery. Surgery. 2004;135(1):21–7.PubMedCrossRefGoogle Scholar
  15. 15.
    Powers KA, Rehrig ST, Irias N, Albano HA, Malinow A, Jones SB, Moorman DW, Pawlowski JB, Jones DB. Simulated laparoscopic operating room crisis: an approach to enhance the surgical team performance. Surg Endosc. 2008;22:885–900.PubMedCrossRefGoogle Scholar
  16. 16.
    Hoffman HM. Teaching and learning with virtual reality. Stud Health Technol Inform. 2000;79:285–91.PubMedGoogle Scholar
  17. 17.
    Torkington J, Smith SG, Rees BI, Darzi A. The role of simulation in surgical training. Ann R Coll Surg Engl. 2000;82:88–94.PubMedGoogle Scholar
  18. 18.
    Satava RM. Surgical education and surgical simulation. World J Surg. 2001;25:1484–9.PubMedCrossRefGoogle Scholar
  19. 19.
    Kneebone J. Simulation in surgical training: educational issues and practical implications. Blackwell Med Educ. 2003;37:267–77.CrossRefGoogle Scholar
  20. 20.
    Joint Services Publication 570: Battlefield Advanced Trauma Life Support. 4th ed. 2008.Google Scholar
  21. 21.
    DeAnda A, Gaba DM. Role of experience in the response to simulated critical incidents. Anesth Analg. 1991;72:308–15.PubMedCrossRefGoogle Scholar
  22. 22.
    Byrne AJ, Jones JG. Inaccurate reporting of simulated critical anaesthetic incidents. Br J Anaesth. 1997;78:637–41.PubMedCrossRefGoogle Scholar
  23. 23.
    Bradley P, Bligh J. One year’s experience with a clinical skills resource centre. Med Educ. 1999;33:114–20.PubMedCrossRefGoogle Scholar
  24. 24.
    Knudson MM, Khaw L, Bullard MK, Dicker R, Cohen MJ, Staudenmayer K, Sadjadi J, Howard S, Gaba D, Krummel T. Trauma training in simulation: translating skills from SIM time to real time. J Trauma. 2008;64(2):255–63; discussion 263–4.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2012

Authors and Affiliations

  1. 1.Queen Mary University of LondonLondonGreat Britain, UK
  2. 2.London Surgical Academy, Cancer InstituteBarts & The London Medical School and NHS TrustLondonUK
  3. 3.Academic Department of Military Surgery and Trauma, Royal Centre for Defense MedicineUniversity Hospital BirminghamBirminghamUK

Personalised recommendations