Brigham Elizabeth M, Hodgman Erica I, Shilkofski Nicole A, Jeffers Justin M, An Daniel, Tackett Sean, Nasr Isam W, Levin Amanda B
West Virginia University Children's Hospital, Morgantown, WV, USA.
Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Adv Simul (Lond). 2025 Jun 17;10(1):34. doi: 10.1186/s41077-025-00363-1.
Traumatic injuries are a significant contributor to pediatric morbidity and mortality, and trauma care necessitates that providers from different specialties and backgrounds be prepared to work together in high acuity settings to provide optimal care. Simulation-based trauma education consistently demonstrates improved knowledge, skill acquisition, teamwork, and task performance among providers, but relatively few studies assess provider performance during real resuscitations. The objective of this study is to develop an interdisciplinary pediatric trauma curriculum to improve trauma bay teamwork and adherence to ATLS ideals in the clinical environment.
We developed a simulation-based pediatric trauma curriculum (Pediatric Trauma Boot Camp) incorporating learners from multiple departments and divisions all of whom care for pediatric trauma patients at our institution. To determine the impact of the curriculum on trauma team clinical performance, videos of trauma activations throughout the multi-year implementation period were reviewed and data abstracted. Teamwork was assessed using the Trauma NOTECHS scale and ATLS compliance by the presence or omission of eight items of the primary and secondary survey. Eighty-six total trainees participated during 2 years of curriculum implementation with faculty from General Pediatric Surgery, Pediatric Emergency Medicine, and Pediatric Critical Care serving as facilitators.
Out of a maximum of 25, the mean total Trauma NOTECHS score for the pre-pilot videos (n = 29) was 14.0. Post-pilot (n = 26), the mean total score improved to 16.8 (p = 0.001). Mean secondary survey completion improved from 4.1/8 pre-pilot to 5.4/8 post-pilot (p = 0.039). No significant difference was observed in primary survey completion between the first two cohorts. Following the second year of curriculum implementation, primary survey completion improved to 6.1/8 in the third cohort (n = 27) from 5.5/8 (p = 0.079). Continued improvement in total Trauma NOTECHS scores was observed (mean = 17.7), and improvements demonstrated in secondary survey completion were preserved.
An interdisciplinary simulation-based pediatric trauma curriculum incorporating learners across specialties has the ability to positively impact provider behavior and direct patient care at a level 1 pediatric trauma center as evidenced by improved teamwork scores and secondary survey completion on video review of live trauma activations.
创伤性损伤是导致儿童发病和死亡的重要因素，创伤护理要求来自不同专业和背景的医护人员准备好在高急症环境中协同工作，以提供最佳护理。基于模拟的创伤教育一直表明，医护人员的知识、技能掌握、团队协作和任务执行能力有所提高，但相对较少的研究评估医护人员在实际复苏过程中的表现。本研究的目的是开发一门跨学科的儿科创伤课程，以改善创伤室的团队协作，并在临床环境中坚持美国创伤生命支持（ATLS）的理念。
我们开发了一门基于模拟的儿科创伤课程（儿科创伤训练营），纳入了来自多个部门和科室的学习者，他们均在我们机构负责护理儿科创伤患者。为了确定该课程对创伤团队临床绩效的影响，我们回顾了多年实施期间创伤启动的视频，并提取了数据。团队协作使用创伤护理技术观察量表（Trauma NOTECHS）进行评估，ATLS依从性则根据初次和二次评估八项内容的有无来判断。在课程实施的两年中，共有86名学员参与，普通儿科外科、儿科急诊医学和儿科重症监护的教员担任指导教师。
在满分25分的情况下，试点前视频（n = 29）的创伤护理技术观察量表总平均分是14.0分。试点后（n = 26），总平均分提高到16.8分（p = 0.001）。二次评估的完成情况从试点前的4.1/8提高到试点后的5.4/8（p = 0.039）。前两个队列在初次评估完成情况方面未观察到显著差异。在课程实施的第二年之后，第三队列（n = 27）的初次评估完成情况从5.5/8提高到6.1/8（p = 0.079）。创伤护理技术观察量表的总平均分持续提高（平均分为17.7），二次评估完成情况的改善也得以保持。
一门跨学科的、基于模拟的儿科创伤课程，纳入了各专业的学习者，能够对一级儿科创伤中心的医护人员行为和直接的患者护理产生积极影响，这在对现场创伤启动视频回顾中团队协作得分提高和二次评估完成情况改善中得到了证明。
