Use of a human patient simulator in the development of resident trauma management skills

Background: Computerized human patient simulators (HPSs) have been used to improve diagnostic and therapeutic decision making, The goal of this study was to investigate the impact of HPSs and Advanced Trauma Life Support (ATL S) on the development of trauma management skills and self-confidence in su rgical interns, Methods: Three teams of interns completed two ATLS-like trauma scenarios on the HPS (pre-ATLS), They then took the ATLS provider course. After ATLS, t he interns were evaluated on two different HPS trauma scenarios (post-ATLS) , Two teams of senior residents, experienced in trauma care, completed the same HPS scenarios and were used as controls. Trauma management skills were scored in three areas-critical treatment decisions, potential for adverse outcomes, and team behavior-by staff trauma surgeons, After participating i n the HPS trauma scenarios, the interns completed self confidence questionn aires and a course evaluation survey, Results: Trauma management skill scores increased 23% in critical treatment decisions, 25% in potential for adverse outcomes, and 47% in team behavior after ATLS/HPS (p < 0.002), Senior residents' performance on HPS trauma sc enarios was better than the interns (p < 0.05) in all three areas evaluated . The interns' self-confidence scores rose significantly after the course. (p < 0.01) The HPS course evaluation survey averaged 8.3 out of a maximum 1 0, Conclusion: Use of HPSs in conjunction with ATLS appears to enhance the dev elopment of trauma management skills, The surgical interns participating in the study deemed the HPS to be a worthwhile experience and a confidence-bu ilding tool, In particular, trauma team behavior improved significantly aft er ATLS/HPS.