International Journal of Healthcare Simulation

Background:

Major trauma is one of the leading contributors to death for several age groups globally making it a public health concern. There are approximately 20,000 cases of major trauma per year in England and over 25% of these result in deaths ^[1]. In an urban trauma unit, since January 2021 there have been 94 major trauma calls with 17 (18.0%) transferred to a major trauma centre. Human factors such as effective communication, leadership, teamwork, situational awareness and understanding of systems are crucial in the assessment and management of trauma patients.

Aim:

This Emergency Medicine (EM) course was designed for Specialty and Associate Specialist Grade (SASG) doctors to develop leadership skills and to demonstrate technical and non-technical skills as a trauma team leader (TTL) when assessing severely injured patients. This course has a strong focus on the understanding of hospital systems and processes for the timely assessment and treatment of complex trauma patients.

Method/design:

After a successful HEE funding bid, a simulation training course was devised to cover the main principles of trauma management and the non-technical skills required to manage a trauma patient and help up-skill the 14 SASG doctors at an urban trauma unit. Five scenarios were designed based on real patients seen in urban trauma units in London. On designing the scenarios, an understanding of the functioning of hospital systems such as requesting and administering blood products and transferring patients both within the hospital and within the trauma network, were crucial learning objectives.

Implementation outline:

This course was delivered weekly from January to June 2021. Sessions involved the EM SASG doctor, two EM nurses and the members of the wider MDT expected at each trauma call, to recreate the resuscitation room environment. Each SASG doctor underwent all five trauma simulation scenarios individually as the TTL. Each scenario was followed by a focussed debrief by two EM consultants, with discussion around human factors, technical and academic aspects of trauma management. All 14 SASG doctors completed the five trauma scenarios. As a result of this training, there has been an improvement in the management of patients with higher injury severity scores in the ED based on both clinical supervision and feedback from the candidates. Given the impact on practice that this training has had, this course will be delivered to the wider trauma teams within the trust, with the EM SASG doctors continuing as TTLs.