Captain Sonar Impact on Trauma Patient Management (CAST2)

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)

Study Overview

• Status: Completed
• Conditions: Trauma Injury
• Intervention / Treatment: Behavioral: Captain Sonar Exposition; Behavioral: Monopoly Exposition

Detailed Description

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.

• Study Type: Interventional
• Enrollment (Actual): 100
• Phase: Not Applicable

Contacts and Locations

Study Locations

• France
  • Rhone
    • Lyon, Rhone, France, 69008
      • Anesthesiology and Intensive care medicine, H Building, Hopital Edouard Herriot, Hospices Civils de Lyon

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

Professional working at the Unit

Exclusion Criteria:

None

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Captain Sonar; 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; 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.
Placebo Comparator: Placebo Monopoly; The control group participants will benefit from a 60 min session to play a "Placebo" game: monopoly	Behavioral: Monopoly Exposition; Participant will be invited to play to Monopoly during 60 min

What is the study measuring?

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

Collaborators and Investigators

• Sponsor: Claude Bernard University
• Collaborators: Laboratoire Interuniversitaire de Biologie de la Motricité; Research on Healthcare Performance Lab U1290

Publications and helpful links

General Publications

• Neily J, Mills PD, Young-Xu Y, Carney BT, West P, Berger DH, Mazzia LM, Paull DE, Bagian JP. Association between implementation of a medical team training program and surgical mortality. JAMA. 2010 Oct 20;304(15):1693-700. doi: 10.1001/jama.2010.1506.
• Gawande AA, Zinner MJ, Studdert DM, Brennan TA. Analysis of errors reported by surgeons at three teaching hospitals. Surgery. 2003 Jun;133(6):614-21. doi: 10.1067/msy.2003.169.
• El-Shafy IA, Delgado J, Akerman M, Bullaro F, Christopherson NAM, Prince JM. Closed-Loop Communication Improves Task Completion in Pediatric Trauma Resuscitation. J Surg Educ. 2018 Jan-Feb;75(1):58-64. doi: 10.1016/j.jsurg.2017.06.025. Epub 2017 Aug 2.

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2021
• Primary Completion (Actual): January 1, 2022
• Study Completion (Actual): February 1, 2022

Study Registration Dates

• First Submitted: May 18, 2022
• First Submitted That Met QC Criteria: November 24, 2022
• First Posted (Actual): November 28, 2022

Study Record Updates

• Last Update Posted (Actual): November 28, 2022
• Last Update Submitted That Met QC Criteria: November 24, 2022
• Last Verified: November 1, 2022

More Information

Terms related to this study

• Keywords: Healthcare professionals; Technical Skills; Non Technical Skills; Crew ressource Management; Stress evaluation and management
• Additional Relevant MeSH Terms: Wounds and Injuries
• Other Study ID Numbers: CAST2 N°20-119

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No