Captain Sonar Impact on Trauma Patient Management

Study Overview
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Brief Summary
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Trauma patient care requires collaboration and interaction with close relationship between many stakeholders from different professions (senior doctor, intern, nurse, nurse helpers, surgeons, etc). This is a stressful situation where decision and action need to be quick, decisive and coordinate. In this situation, quality of care and patient safety depends on a good interprofessional communication. The acquisition of advanced communication skills, team management and leadership, stress management are essentials elements in the practice of Intensive and trauma care. However, advanced structured training or assessment of theses skills is lacking in medical education or Healthcare professionals training. The study therefore, aimed to develop a global and attractive training to help healthcare professionals to improve their skills. Captain SonarTM is a naval battle game where two teams each composed of four participants clash. Each player has a well-defined role and it is imperative to communicate in a closed loop to advance in the game. This game also includes components similar to support for shock management: stress, speed of action, central communication and teamwork of four protagonists (Team Leader-Captain, intern-Second, nurse-Mechanic, Nurse help-Detector). It may improve team building, team leadership, interprofessional work, communication, stress management. The study hypothesis is that this board game would have an impact on the performance of professionals when facing a multiple trauma simulated patient. (differences in terms of technical and non-technical performance. Different use of closed loop communication, Different stress management, different efficiency and interprofessional collaboration with potentially a reduction in the timing of treatment being delivered in trauma room)

Detailed Description
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All the teams of 4 participants and 1 medical Student previously trained will then benefit from a training session either exposed to captain sonar or into the control arm with monopoly. High-fidelity and multiprofessional simulation session based on the incoming of a severe traumatized patient will be held. These sessions will take place on high-fidelity mannequins lent by the CLESS (Lyonnais Center for Health Simulation Education) in pavilion H of Édouard Herriot Hospital, within the Trauma Center (in situ). The same scenario will be presented for all groups (exposed and controls) with the same objectives of realization and the same complexity. An audio-visual recording will take place during each session in order to allow the evaluation of the study criteria on technical and non technical skills between the participants a posteriori of the simulation session.

Official Title
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Captain Sonar Impact on Trauma Patient Management

Conditions
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Trauma Injury

Intervention / Treatment
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* Behavioral: Captain Sonar Exposition
* Behavioral: Monopoly Exposition


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Professional working at the Unit Exclusion Criteria: None

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Randomized control Trial, double blind
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Captain Sonar<br>Participants will receive a training by a game session at Captain SonarTM of 60 min (including 15 min of presentation and prize in hand of the game) against a standardized investigator team | Behavioral: Captain Sonar Exposition<br>* Captain SonarTM is a naval battle game where two teams each composed of four participants clash. Each player has a well-defined role and it is imperative to communicate in a closed loop to advance in the game. This game also includes components similar to support for Trauma care: stress, speed of action, central communication and teamwork of four protagonists (Team Leader- Captain, intern-Second, nurse-Mechanic, Caregiver-Detector). This short video describes the rules and the Game progress: https://vimeo.com/173614346.<br>|
| Placebo Comparator: Placebo Monopoly<br>The control group participants will benefit from a 60 min session to play a Placebo game: monopoly | Behavioral: Monopoly Exposition<br>* Participant will be invited to play to Monopoly during 60 min<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Technical skills | Total time of care in the trauma room, in seconds | Measured during simulation session. Within 20 minutes of the simulation | 
| Non technical skills | use of closed loop communications: - count of the number of closed loops/minute | Measured during simulation session. Within 20 minutes of the simulation | 
| Stress profile and stress management | Visual Analog Scale of Stress, from 0 to 100 maximum | immediately after simulation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Demographic data | Demographic data (sex, age, previous experience as health care professional, experience in simulation, experience in gaming, experience in stress management) | At Baseline | 
| Debriefing Evaluation | Debriefing Assessment in Simulation in Healthcare (DASH) evaluated by team leader, nurse and facilitator, from 6 to 42 maximum | immediately After Debriefing | 
| Influence of exposure on Performance, communication and stress management | Visual analogic Scale, from 0 to 100 maximum | immediately After simulation | 
| Technical skills grid | Technical performance score (Grid out of 100 points); from 0 to 100 maximum | Measured during simulation session. Within 20 minutes of the simulation. | 
| Technical skills key tasks | Completion time for 5 key tasks (Hemocue result, blood pressure result, sample) in seconds Blood, realization of the FAST Ultrasound, Departure for OR/CT). | Measured during simulation session. Within 20 minutes of the simulation. | 
| Technical skills self efficacy | Self Efficacy estimation on Several cases, from 0 to 100 maximum Visual analog scale of support performance felt after the simulation session; | Measured during simulation session. Within 20 minutes of the simulation. | 
| Non technical skills crew ressource 1 | Non technical skills score : from 0 to 54 maximum | Measured during simulation session. Within 20 minutes of the simulation. | 
| Non technical skills crew ressource 2 | Non technical skills Score 2: from 1 to 5 maximum | Measured during simulation session. Within 20 minutes of the simulation. | 
| Non technical skills communication anticipation | Rate of anticipation of each participation (initiation of an act without prior request by the Team leader); | Measured during simulation session. Within 20 minutes of the simulation. | 
| Non technical skills quality of team communication | Visual Analog Scale quality of team communication, from 0 to 100 maximum. | immediately after simulation | 
| Non technical skills confidence for team leader | Visual Analog Scale of confidence in the team and the team leader , from 0 to 100 maximum. | immediately after simulation | 
| Visual Analog Scale type of stress | Visual Analog Scale of stress | immediately after the simulation session | 
| Anxiety profile | Stait Trait Anxiety Inventory Trait, from 20 to 80 maximum. | immediately after the simulation session; | 
| Stress profiles and stress management physiological measurement heart rate variability | Physiological stress assessment of 2 of each team members will be performed throughout inclusion (during exposure and during simulation) and measured by non-invasive and continuous recording: - Heart and respiratory rates and heart rate variability (Hexoskin® t-shirt) | During Simulation within the 20 minutes of simulation | 
| Stress profiles and stress management electrodermal activity | Electrodermal activity, reflecting the stress and activation of individuals (Empatica E4 watch on the wrist non-dominant) | During Simulation within the 20 minutes of simulation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Healthcare professionals, Technical Skills, Non Technical Skills, Crew ressource Management, Stress evaluation and management