Introduction: Trauma teams are comprised of a diverse group of interprofessional providers. While there are different configurations, teams commonly consist of physicians, nurses, emergency medical technicians, various hospital-based technicians and administrative staff. There are currently a plethora of task trainers and simulators available for training; however, none address the unique needs of an interprofessional trauma team. Proper trauma team training requires realistic, real-time patient evaluation and management throughout the continuum of care from prehospital stabilization to definitive hospital care. Currently the best platform for this training is live tissue. The tactile sensation and challenges of handling real tissue is not currently matched with simulation technology. However, while the gold standard for trauma training, the animal models still fall short in many aspects. These include not being anatomically correct in size or structure, not being able to provide scenario specific vital signs that respond to interventions, and being unpredictable in their ability to complete the event. These live tissue model challenges, coupled with increasing pressure to stop the use of animals for training, and a lack of an adequate replacement, suggest an alternative is needed.
Description: Trauma experts were queried on features that an ideal trauma team simulator would incorporate. Analysis of current trainers and simulators was conducted. Findings revealed the need for a full-sized human simulator. For this proof of concept study the Laerdal ALS simulator and Strategic Operations Surgical Cut Suit were selected to create a hybrid simulator due to their capabilities to electronically and physically look and behave like a real trauma patient. Operators and evaluators were trained on standardized scenarios that would challenge a trauma team throughout the continuum of care. Trauma teams received orientation to the hybrid and its capabilities. Operators, evaluators and students conducted post-training surveys. The hybrid simulator was able to challenge all team members simultaneously, at the various stages within the continuum of care. The simulator was more anatomically correct, appeared more human, and provided realistic, real-time visual and physical signs and symptoms. The hybrid allowed for numerous interventions and procedures to be conducted in all settings. Less clinical errors, better performed initial procedures, and more complete documentation were noted by the evaluators. However, the surgical procedures were noted to be inferior to that of animal models.
Conclusion: While there are numerous prehospital and hospital setting simulators, none fully meets the training needs of a diverse interprofessional trauma team. Simulators must challenge multiple aspects of the team ranging from individual patients to MASCAL situations; penetrating, blunt, thermal and mixed trauma; varied resuscitation and surgical needs; and be capable of challenging all participants simultaneously throughout the continuum of care in real-time. Currently available products do not have the features required to simulate a patient from point of injury to post-surgical recovery. Animal models have great characteristics, but limitations too. Many live tissue limitations are addressed with our full-sized human hybrid simulator. It has the benefit of providing appropriate initial and variable vitals, accommodates almost most prehospital and emergency room interventions and procedures, has a moderate level of surgical capabilities, and can challenge the staff in the post surgical area. Further modification of this hybrid simulator will allow for more capabilities. Our goal was to begin to address this unmet need in healthcare simulation with the hopes that industry will advance the field and granting agencies will begin to fund needed technologies and educational outcomes studies.
(C) 2014 Society for Simulation in Healthcare