Young Scott E, Davis Gerrit W, Thomas Drew M, Pham Tam N, Couperus Kyle
Department of Emergency Medicine, University of Washington School of Medicine, Seattle, USA.
Department of Emergency Medicine, Madigan Army Medical Center, Tacoma, USA.
Cureus. 2024 Nov 20;16(11):e74102. doi: 10.7759/cureus.74102. eCollection 2024 Nov.
Assessing proficiency in the initial management of a traumatically injured patient is challenging. Previously developed scoring tools frequently looked to evaluate single domains of a trauma leader or team's performance. An updated multi-domain scoring tool is needed to evaluate individual and group performance in the initial phases of trauma resuscitation.
The modified Delphi technique was used to improve and obtain consensus on a multi-domain trauma training score (TTS). Subject matter experts (SMEs) in trauma across the United States were contacted electronically to consider voluntary participation in this study. Elective participants electronically received and commented on statements related to the 10 separate domains of a proposed TTS. These statements were evaluated using a 5-point Likert scale ranging from "Strongly Agree" to "Strongly Disagree". Feedback from the SMEs was used to modify each domain that did not receive consensus, and repeat iterations were performed until 80% or greater consensus was achieved. Internal consistency was measured using Cronbach's-ɑ, with a goal of greater than 0.8.
Twenty-eight SMEs elected to participate in the modified Delphi process representing emergency medicine, trauma surgery, and critical care. Consensus was achieved when 80% or greater of the SMEs responded with a 4 or a 5 to each statement. Four total rounds of review and modification were required to achieve consensus on all statements. Cronbach's-ɑ for each round was greater than 0.85.
A unifying standardized outcome for measuring performance in the initial phases of trauma resuscitation is needed. The TTS developed in this study used expert consensus to provide a multi-domain means of evaluating trauma practitioners of all levels in both live and simulated patients.
评估对创伤患者进行初始治疗的熟练程度具有挑战性。先前开发的评分工具通常旨在评估创伤领导者或团队表现的单一领域。需要一种更新的多领域评分工具来评估创伤复苏初始阶段的个人和团队表现。
采用改良的德尔菲技术来改进多领域创伤训练评分（TTS）并达成共识。通过电子邮件联系了美国各地的创伤领域专家，邀请他们自愿参与本研究。参与的专家通过电子邮件接收并对与拟议的TTS的10个不同领域相关的陈述发表评论。这些陈述使用从“强烈同意”到“强烈不同意”的5点李克特量表进行评估。专家的反馈用于修改未达成共识的每个领域，并反复进行迭代，直到达成80%或更高的共识。使用克朗巴哈系数测量内部一致性，目标是大于0.8。
28名专家选择参与改良的德尔菲过程，他们分别代表急诊医学、创伤外科和重症监护领域。当80%或更多的专家对每条陈述给出4或5的回答时，达成了共识。总共需要四轮审查和修改才能就所有陈述达成共识。每一轮的克朗巴哈系数均大于0.85。
需要一个统一的标准化结果来衡量创伤复苏初始阶段的表现。本研究中开发的TTS利用专家共识，提供了一种多领域方法，用于评估在真实患者和模拟患者中各级创伤从业者的表现。
