The REBOA Dissipation Curve: Training Starts to Wane at 6 Months in the Absence of Clinical REBOA Cases

Justin S. Hatchimonji, Jennifer Sikoutris, Brian P. Smith, Michael A. Vella, Ryan P. Dumas, Zaffer A. Qasim, John J. Gallagher, Patrick M. Reilly, Shariq S. Raza, Jeremy W. Cannon

Research output: Contribution to journalArticle

Abstract

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a low-frequency, high-acuity intervention. We hypothesized that REBOA-specific knowledge and comfort deteriorate significantly within 6 months of a formal training course if REBOA is not performed in the interim. Methods: A comprehensive REBOA course was developed including didactics and hands-on practical simulation training. Baseline knowledge and comfort were assessed with a precourse objective test and a subjective self-assessment. REBOA knowledge and comfort were then re-assessed immediately postcourse and again at 6 months and 1 year. Performance trends were measured using paired Student's t and Wilcoxon signed-rank tests. Results: Thirteen participants were evaluated including trauma faculty (n = 10) and fellows (n = 3). Test scores improved significantly from precourse (72% ± 10% correct) to postcourse (88% ± 8%, p < 0.001). At 6 months, scores remained no different from postcourse (p = 0.126); at 1 year, scores decreased back to baseline (p = 0.024 from postcourse; 0.285 from precourse). Subjective comfort with femoral arterial line placement and REBOA improved with training (p = 0.044 and 0.003, respectively). Femoral arterial line comfort remained unchanged from postcourse at 6 months (p = 0.898) and 1 year (p = 0.158). However, subjective comfort with REBOA decreased relative to postcourse levels at 6 months (p = 0.009), driven primarily by participants with no clinical REBOA cases in the interim. Conclusions: A formal REBOA curriculum improves knowledge and comfort with critical aspects of this procedure. This knowledge persists at 6 months, though subjective comfort deteriorated among those without REBOA placement in the interim. REBOA refresher training should be considered at 6-month intervals in the absence of clinical REBOA cases. Level of Evidence/Study type: Level III, prognostic.

Original languageEnglish (US)
JournalJournal of Surgical Education
DOIs
StateAccepted/In press - 2020

Keywords

  • REBOA
  • resuscitative endovascular balloon occlusion of aorta
  • simulation
  • surgical education

ASJC Scopus subject areas

  • Surgery
  • Education

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    Hatchimonji, J. S., Sikoutris, J., Smith, B. P., Vella, M. A., Dumas, R. P., Qasim, Z. A., Gallagher, J. J., Reilly, P. M., Raza, S. S., & Cannon, J. W. (Accepted/In press). The REBOA Dissipation Curve: Training Starts to Wane at 6 Months in the Absence of Clinical REBOA Cases. Journal of Surgical Education. https://doi.org/10.1016/j.jsurg.2020.05.003