Advanced Surgical Skills for Exposure in Trauma (ASSET) course improves military surgeon confidence

Authors

  • Rebecca A. Saberi, MD, MSPH
  • Graham B. Parker, MD https://orcid.org/0000-0002-0446-3446
  • Noreen Mohsin, MD
  • Gareth P. Gilna, MD, MSPH
  • Alessia C. Cioci, MD
  • Eva M. Urrechaga, MD
  • COL Mark D. Buzzelli, MD
  • Carl I. Schulman, MD, PhD, MSPH
  • Kenneth G. Proctor, PhD
  • LTC (ret) George D. Garcia, MD

DOI:

https://doi.org/10.5055/ajdm.0469

Keywords:

Advanced Surgical Skills for Exposure in Trauma, military surgery, deployment, surgical skills, trauma surgery

Abstract

Objective: Active duty military surgeons often have limited trauma surgery experience prior to deployment. Consequently, military-civilian training programs have been developed at high-volume trauma centers to evaluate and maintain proficiencies. Advanced Surgical Skills for Exposure in Trauma (ASSET) was incorporated into the predeployment curriculum at the Army Trauma Training Detachment in 2011. This is the first study to assess whether military surgeons demonstrated improved knowledge and increased confidence after taking ASSET.

Design: Retrospective cohort study.

Setting: Quaternary care hospital.

Patients and participants: Attending military surgeons who completed ASSET between July 2011 and October 2020.

Main outcome measure(s): Pre- and post-course self-reported comfort level with procedures was converted from a five-point Likert scale to a percentage and compared using paired t-tests.

Results: In 188 military surgeons, the median

time in practice was 3 (1-8) years, with specialties in general surgery (52 percent), orthopedic surgery (29 percent), trauma (7 percent), and other disciplines (12 percent). The completed self-evaluation response rate was 80 percent (n = 151). The self-reported comfort level for all body regions improved following course completion (p < 0.001): chest (27 percent), neck (23 percent), upper extremity (22 percent), lower extremity (21 percent), and abdomen/pelvis (19 percent). The overall score on the competency test improved after completion of ASSET, with averages increasing from 62 ± 18 percent pretest to 71 ± 13 percent post-test (p < 0.001).

Conclusions: After taking the ASSET course, military surgeons demonstrated improved knowledge and increased confidence in the operative skills taught in the course. The ASSET course may provide sustainment of knowledge and confidence if used at regular intervals to maintain trauma skills and deployment readiness.

Author Biographies

Rebecca A. Saberi, MD, MSPH

Division of Trauma, Acute Care Surgery, and Surgical Critical Care, University of Miami/Ryder Trauma Center at Jackson Memorial Hospital, Miami, Florida

Graham B. Parker, MD

Department of Medicine, Los Angeles General Medical Center, Los Angeles, California

Noreen Mohsin, MD

Department of Dermatology, Cleveland Clinic, Cleveland, Ohio

Gareth P. Gilna, MD, MSPH

Division of Trauma, Acute Care Surgery, and Surgical Critical Care, University of Miami/Ryder Trauma Center at Jackson Memorial Hospital, Miami, Florida

Alessia C. Cioci, MD

Division of Trauma, Acute Care Surgery, and Surgical Critical Care, University of Miami/Ryder Trauma Center at Jackson Memorial Hospital, Miami, Florida

Eva M. Urrechaga, MD

Division of Trauma, Acute Care Surgery, and Surgical Critical Care, University of Miami/Ryder Trauma Center at Jackson Memorial Hospital, Miami, Florida

COL Mark D. Buzzelli, MD

Division of Trauma, Acute Care Surgery, and Surgical Critical Care, University of Miami/Ryder Trauma Center at Jackson Memorial Hospital, Miami, Florida

Carl I. Schulman, MD, PhD, MSPH

Division of Trauma, Acute Care Surgery, and Surgical Critical Care, University of Miami/Ryder Trauma Center at Jackson Memorial Hospital, Miami, Florida; Department of Dermatology, Cleveland Clinic, Cleveland, Ohio

Kenneth G. Proctor, PhD

Division of Trauma, Acute Care Surgery, and Surgical Critical Care; United States Army Trauma Training Detachment, University of Miami/Ryder Trauma Center at Jackson Memorial Hospital, Miami, Florida

LTC (ret) George D. Garcia, MD

Division of Trauma, Acute Care Surgery, and Surgical Critical Care; United States Army Trauma Training Detachment, University of Miami/Ryder Trauma Center at Jackson Memorial Hospital, Miami, Florida

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Published

02/01/2024

How to Cite

Saberi, R. A., G. B. Parker, N. Mohsin, G. P. Gilna, A. C. Cioci, E. M. Urrechaga, M. D. Buzzelli, C. I. Schulman, K. G. Proctor, and G. D. Garcia. “Advanced Surgical Skills for Exposure in Trauma (ASSET) Course Improves Military Surgeon Confidence”. American Journal of Disaster Medicine, vol. 19, no. 1, Feb. 2024, pp. 45-51, doi:10.5055/ajdm.0469.

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