Portal de Periódicos da CAPES

Assessing leadership and clinical performance of pediatric emergency medicine providers during level 1 trauma resuscitations using video review

2016; Volume: 2; Issue: 1 Linguagem: Inglês

10.15761/tec.1000118

2398-3345

Erin B. Henkel, Esther M. Sampayo, Elizabeth A. Camp, Bindi Naik‐Mathuria, Corrie E. Chumpitazi, David E. Wesson, Daniel M. Rubalcava,

Disaster Response and Management

Background: A modified non-technical skills scale for trauma (T-NOTECHS) for assessment of leadership skills in trauma resuscitations has been described in surgical literature.The utility of this tool with Pediatric Emergency Medicine (PEM) providers has not been explored.The objectives of this study were to assess the utility of the T-NOTECHS scoring tool in the pediatric setting and identify barriers to leading a thorough and efficient trauma evaluation. Methods:We conducted a mixed-methods study utilizing video review and semi-structured interviews of PEM team leaders of Level 1 trauma resuscitations at a quaternary children's hospital.Resuscitation videos were scored using T-NOTECHS by 5 or more reviewers from different disciplines: PEM physicians, pediatric surgeons, and non-physicians including nurses and advanced practice providers (RN/APPs).Median scores were compared using intraclass correlation coefficients (ICC).A sample of subjects scored their own videos and participated in a semi-structured interview.Two coders conducted thematic analysis to identify perceived barriers in leading efficient trauma resuscitations, and member checking was completed.Results: Thirty trauma resuscitations were reviewed and analyzed; twenty-eight had complete data from all groups.T-NOTECHS scores were highest in the PEM self-review group, followed by surgeons and PEM physicians.RN/APPs scored leaders lowest.There was moderate to substantial ICC agreement between all groups.Four principal themes emerged as perceived barriers to leading efficient trauma resuscitations: communication issues, resource limitations, the role of learners, and a lack of standardization and consistency among providers. Conclusions:The T-NOTECHS score is a useful tool in evaluating PEM leadership competency during trauma resuscitations and demonstrates reliability amongst scores obtained from reviewer groups with varied trauma experience and training.Systematic interviews of team leaders can identify barriers and means to improve the quality and efficiency of Level 1 trauma evaluations.