Nicole Augat (Ulm / DE), Benedikt Friemert (Ulm / DE), Alexander Reckziegel (Ulm / DE), Dan Bieler (Koblenz / DE), Markus Blätzinger (Munich / DE), Axel Franke (Koblenz / DE), Gerhard Achatz (Ulm / DE)
Purpose
The threat of terror is omnipresent in Europe and the number of attacks worldwide is increasing. The target of attacks in Europe is usually the civilian population. Incalculable dangerous situations at the scene of the event and severe injury patterns such as complex gunshot and explosion injuries with a high number of highly life-threatening people present rescue forces, emergency physicians and subsequently hospitals with medical, organizational as well as tactical-strategic challenges.
The Terror and Disaster Surgical Care (TDSC®) - course trains clinical decision makers to meet these challenges of a TerrorMASCAL in the first 24 to 48 hours.
Methods
A table-top - exercise was developed for the TDSC® - course as a decision training tool, which was prospectively evaluated in six courses. The evaluation took place in 3 courses of the version 1.0, in 3 courses in the further developed version 2.0 to different target values like e.g. the accuracy of the in-hospital triage. Further one 16 TDSC® - course instructors were also evaluated.
Results
For the evaluation n=360 patient charts for version 1.0 and n=369 for version 2.0 could be evaluated. Overall, the table-top exercise was found to be suitable for training of internal clinical decision-makers. Version 2.0 was also able to depict the action and decision-making paths in a stable and valid manner compared to the previous version 1.0. The evaluation of the instructors also confirmed the further value and improvement of version 2.0.
Conclusion
With this prospective study, the table-top - exercise of the TDSC® - course was tested for decision stability and consistency of the participants' decision paths. This could be proven for the selected target variables, it further showed an improvement of the training situation. A further development of the table-top - exercise, in particular also using digital modules, will allow a further optimization.
Reckziegel A is a medical doctoral student evaluating the TDSC course and its simulation game, Achatz G, Friemert B, Franke A and Bieler D are developers of the TDSC course and active as course directors/instructors. Blätzinger M work for the AUC - Academy for Trauma Surgery GmbH and are organisers of the TDSC course.
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