HCBE Faculty Articles

Document Type

Article

Publication Title

Military Medicine

ISSN

0026-4075

Publication Date

2014

Abstract/Excerpt

Objectives: Reducing preventable deaths because of uncontrolled hemorrhage, tension pneumothorax, and airway loss is a priority. As part of a research initiative comparing different training models, this study evaluated the reliability and validity of a test that assesses combat medic performance during a polytrauma scenario using live animal models.

Methods: Nine procedural checklists and seven global rating scales were piloted with four cohorts of soldiers (n = 94) at two U.S. training sites. Cohorts represented “novice” to “proficient” trainees. Procedure scores and a mean global score were calculated per subject. The intraclass correlation was calculated per procedure, with 0.70 as the threshold for acceptability. An overall difference among cohorts was hypothesized: Cohort 4 (proficient) > Cohort 3 (competent) > Cohort 2 (beginners) > Cohort 1 (novice) trainees. Data were analyzed using Kruskal–Wallis and analysis of variance. Results: At Site A, intraclass correlation coefficients ranged from 74% to 93% for 6 of 9 procedures. Cohorts differed significantly on hemorrhage control, needle decompression, cricothyrotomy, amputation management, chest tube insertion, and mean global scores. Cohort 4 outperformed the others, and Cohorts 2 and 3 outperformed Cohort 1.

Conclusion: The test differentiates novices from beginners, competent, and proficient trainees on difficult procedures and overall performance.

DOI

https://doi.org/10.7205/MILMED-D-13-00247

Volume

179

Issue

1

First Page

42

Last Page

48

Comments

We thank COL Annette Hildabrand, Deputy Director, DoD Clinical Use Programs OSD/ASD R&E; COL Randall Anderson, AMEDD; Camp Bullis BCT-3 course personnel; Greg T. Rule, P.E. (ARA); MedSim CCTC team members: Mike Fite, Richard W. Bianco, Peggy Norris, Danielle Hart, MD, Cullen Hegarty, MD, Mary Ann McNeil, MA, EMT-P, Daniel Chan, PMP, and Rachael Chan.

Funding Information

This work is supported by the U.S. Army Medical Research and Materiel Command under Cooperative Agreement Number W81XWH-11-2-0185.

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