Determining the Educational Impact of Virtual Patients on Trauma Team Training during a Multinational, Large Scale Civil Military Simulation Exercise.

BACKGROUND: With asymmetrical conflicts ongoing, many countries have an increasing number of major trauma events but limited capacity to cope with these events. Training for such events comprises primarily of simulations requiring significant resources, time consuming and expensive. Virtual patients are defined as computer-based programs presenting authentic cases and supports training in trauma management.

HYPOTHESIS: Assisted learning technologies augment simulated trauma team training and can improve trauma team competencies. The aim was to investigate if virtual patients increased competencies in decision making required and to identify deficiencies in care for the management of trauma patients during a multinational civil military trauma exercise.MethodsProspective educational intervention study with mixed methods, measuring the effects of a novel virtual patient model on trauma teams. The population consisted of surgeons, anaesthesiologists, emergency room physicians, nurses and paramedics (n = 30), and constituted six trauma teams from eight countries; three trauma teams formed the participating group and three were allocated as control group. The participating group was exposed to virtual patients pre-, during and post the live simulation exercise. Data sources derived from: individual pre- and post-assessments, evaluations made by experts in trauma and video-recordings of performance during the live simulation exercise and analyzed by the thematic analysis method.

RESULTS: Utilizing virtual patients contributed to improved individual knowledge about the management of major trauma patients and improved teamwork. Virtual patients as support for reasoning in decision making, were directly correlated to level of previous knowledge and experience. Two of the three participating trauma teams showed lower levels of existing knowledge and competence in managing major trauma patients and therefore made more efficient use of the virtual patients.

CONCLUSIONS: Results demonstrated advantages utilizing virtual patients during a major civil military trauma live simulation exercise and appear to be supportive especially for teams who are not as experienced.

LEVEL OF EVIDENCE: Level IV, prospective educational intervention study.