Improving Pediatric Trauma Education by Teaching Non-technical Skills: A Randomized Controlled Trial

Fabio Botelho; Ayla Gerk; Jason M Harley; Dan Poenaru

doi:10.1016/j.jpedsurg.2024.01.018

Improving Pediatric Trauma Education by Teaching Non-technical Skills: A Randomized Controlled Trial

J Pediatr Surg. 2024 May;59(5):874-888. doi: 10.1016/j.jpedsurg.2024.01.018. Epub 2024 Feb 1.

Authors

Fabio Botelho¹, Ayla Gerk², Jason M Harley³, Dan Poenaru⁴

Affiliations

¹ Department of Surgery, McGill University, Montreal General Hospital, Montreal, Canada; Harvey E. Beardmore Division of Pediatric Surgery, Montreal Children's Hospital, Montreal, Canada. Electronic address: fabio.botelho@mail.mcgill.ca.
² Department of Surgery, McGill University, Montreal General Hospital, Montreal, Canada.
³ Department of Surgery, McGill University, Montreal General Hospital, Montreal, Canada; Steinberg Centre for Simulation and Interactive Learning, McGill University, Montreal, Canada; Institute of Health Sciences Education, McGill University, Montreal, Canada; Research Institute of the McGill University Health Centre, Montreal, Canada.
⁴ Department of Surgery, McGill University, Montreal General Hospital, Montreal, Canada; Harvey E. Beardmore Division of Pediatric Surgery, Montreal Children's Hospital, Montreal, Canada; Institute of Health Sciences Education, McGill University, Montreal, Canada; Research Institute of the McGill University Health Centre, Montreal, Canada.

PMID: 38369400
DOI: 10.1016/j.jpedsurg.2024.01.018

Abstract

Background: Pediatric trauma is a significant cause of child mortality, and the absence of non-technical skills (NTS) among health providers is linked with errors in patients' care. In this study, we evaluate the effectiveness of a structured debriefing protocol in enhancing NTS during pediatric trauma simulation.

Methods: A total of 45 medical students were successfully recruited from two medical schools, one in Brazil and one in Canada. Medical students were assigned to a control (N = 20) or intervention group (N = 25) in a randomized control trial. Following simulated scenarios, participants in the intervention group underwent NTS debriefing, while the control received standard debriefing based on the Advanced Trauma Life Support (ATLS) protocol. Students' confidence, NTS level, and performance were measured through self-assessment surveys, the Non-Technical Skills for Surgeons (NOTSS) score, and adherence to the trauma protocol, respectively. Baseline characteristics and outcomes were compared using t-tests, Mann-Whitney, Wilcoxon signed-rank Kruskal-Wallis, ANOVA, and a repeated-measures ANCOVA. A significance level was set at p < 0.05.

Results: The workshop increased students' confidence in leading trauma resuscitation regardless of their assignment to condition. While controlling for covariates, students in the intervention group significantly improved their overall NOTSS compared to those in the control and in all categories: situational awareness, decision-making, communication and teamwork, and leadership. The intervention teams also demonstrated a significant increase in completing trauma protocol steps.

Conclusion: Implementing structured debriefing focusing on NTS enhanced these skills and improved adherence to protocol among medical students managing pediatric trauma-simulated scenarios. These findings support integrating NTS training in pediatric trauma education.

Level of evidence: I.

Keywords: Child; Communication; Health education; Leadership; Simulation training; Wounds and injuries.

Publication types

Randomized Controlled Trial

MeSH terms

Awareness
Canada
Child
Clinical Competence*
Curriculum
Humans
Simulation Training* / methods