Trauma operative skills in the era of nonoperative management: the trauma exposure course (TEC).

Mark Gunst, Terence O'Keeffe, Lisa Hollett, Mark Hamill, Larry M. Gentilello, Heidi Frankel, Shahid Shafi

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Declining trauma operative experience adversely impacts learning and retention of operative skills. Current solutions, such as acute care surgery, may not provide relevant operative experience. We hypothesized that a structured skills curriculum using fresh cadavers would improve participants' self-confidence in surgical exposure of human anatomic structures for trauma. METHODS: The trauma exposure course, a single-day, 8-hour course with two trainees and one instructor per fresh cadaver, was designed by the faculty of a high-volume, urban, level I trauma center. Trainees included all trauma fellows (n = 6) and surgical chief residents (n = 12) in academic year 2007 to 2008. Using a structured, pretested curriculum, participants were trained by trauma faculty in operative exposure of 48 structures in the neck, chest, abdomen, pelvis, and extremities. For each exposure, participants' self-reported levels of operative confidence were measured using the operating score (OR score, 1 = not confident and 5 = highly confident) before the course (pre), immediately afterward (post), and at long-term follow-up (median, 6 months). RESULTS: Participation in the trauma exposure course resulted in a significant increase in OR scores for 44 of the 48 exposures (median scores, pre 3 vs. post 5, p < 0.0001), with no decline at long-term follow-up. Participants with less previous operative experience were most likely to benefit from the course. CONCLUSION: A structured skills curriculum using fresh cadavers improved participants' self-confidence in operative skills required for surgical exposure of human anatomic structures for trauma. This model of training may be beneficial for surgical residents and fellows, as well as practicing trauma surgeons.

Original languageEnglish (US)
Pages (from-to)1091-1096
Number of pages6
JournalThe Journal of trauma
Volume67
Issue number5
StatePublished - Nov 2009

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Wounds and Injuries
Cadaver
Curriculum
Trauma Centers
Pelvis
Abdomen
Neck
Thorax
Extremities
Learning

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Gunst, M., O'Keeffe, T., Hollett, L., Hamill, M., Gentilello, L. M., Frankel, H., & Shafi, S. (2009). Trauma operative skills in the era of nonoperative management: the trauma exposure course (TEC). The Journal of trauma, 67(5), 1091-1096.

Trauma operative skills in the era of nonoperative management : the trauma exposure course (TEC). / Gunst, Mark; O'Keeffe, Terence; Hollett, Lisa; Hamill, Mark; Gentilello, Larry M.; Frankel, Heidi; Shafi, Shahid.

In: The Journal of trauma, Vol. 67, No. 5, 11.2009, p. 1091-1096.

Research output: Contribution to journalArticle

Gunst, M, O'Keeffe, T, Hollett, L, Hamill, M, Gentilello, LM, Frankel, H & Shafi, S 2009, 'Trauma operative skills in the era of nonoperative management: the trauma exposure course (TEC).', The Journal of trauma, vol. 67, no. 5, pp. 1091-1096.
Gunst M, O'Keeffe T, Hollett L, Hamill M, Gentilello LM, Frankel H et al. Trauma operative skills in the era of nonoperative management: the trauma exposure course (TEC). The Journal of trauma. 2009 Nov;67(5):1091-1096.
Gunst, Mark ; O'Keeffe, Terence ; Hollett, Lisa ; Hamill, Mark ; Gentilello, Larry M. ; Frankel, Heidi ; Shafi, Shahid. / Trauma operative skills in the era of nonoperative management : the trauma exposure course (TEC). In: The Journal of trauma. 2009 ; Vol. 67, No. 5. pp. 1091-1096.
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